DR. KRISTIN LEE BEASLEY (NPI# 1104237833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104237833 |
| Entity Type | Individual |
| Full Name | DR. KRISTIN LEE BEASLEY |
| Practice Address |
2080 N Winery Ave #101 Fresno CA 93703-4817 |
| Practice Telephone | 5592526353 |
| Mailing Telephone | 5592526353 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
PSB94020449 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSB94020449 | CA | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
PSB94020449 | CA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSB94020449 | CA | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
PSB94020449 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922296763 | Kristin Beasley | Speech-Language Pathologist | 10025 W Angels Ln, Peoria, AZ 85383-3198 | 2007-10-05 |
| 1194900944 | Kristin Nicole Beasley | Veterinarian | 1093 Sandy Plains Rd, Marietta, GA 30066-6537 | 2007-12-28 |
| Street Address |
2080 N WINERY AVE #101 |
| City | FRESNO |
| State | CA |
| Zip Code | 93703-4817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396156030 | Edwyn W. Ortiz-nance Psychological Services | Exclusive Provider Organization | 2080 N Winery Ave, #101, Fresno, CA 93703-4817 | 2014-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396395638 | Angelica Gomez | Behavior Technician | 1535 N. Cedar Ave Apt 159, Fresno, CA 93703 | 2019-09-18 |
| 1326521659 | Skylar Nunes | Licensed Vocational Nurse | 3133 N. Millbrook Ave, Fresno, CA 93703 | 2018-09-12 |
| 1700379377 | Heather Rae Mann | Counselor | 3133 N Miibrook Ave, Fresno, CA 93703 | 2018-06-08 |
| 1891296422 | Guardian Angel's Adult Day Healt Care, LLC | Clinic/Center | 4837 E. Mckinley Avenue, Fresno, CA 93703 | 2018-02-28 |
| 1275052987 | Diana Christine Garnica | Nurse Practitioner | 4950 E Clinton Ave, Fresno, CA 93703 | 2017-09-13 |
| 1639609241 | Ryan Ruhl | Case Manager/Care Coordinator | 3133 N Millbrook Ave., Fresno, CA 93703 | 2017-06-15 |
| 1972034221 | Anna Garcia | Counselor | 1505 N Chestnut, Fresno, CA 93703 | 2017-03-27 |
| 1306227947 | Innovations Counseling Services | Health Maintenance Organization | 2100 Wst. Winery Ave, 101, Fresno, CA 93703 | 2015-06-09 |
| 1639592553 | Janelle K Raynor | Counselor | 1911 East Princeton Avenue, Fresno, CA 93703 | 2014-01-29 |
| 1104166297 | Jessica Marie Flowers-guerrero | Marriage & Family Therapist | 3133 N. Millbrook Ave., Fresno, CA 93703 | 2013-02-26 |
| Find all providers in zip 93703 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568096121 | Amy Mouanoutoua | Psychologist | 2109 W Bullard Ave Ste 121, Fresno, CA 93711-1258 | 2020-02-23 |
| 1407378771 | Robert David Wells | Psychologist | 1100 W Shaw Ave Ste 134, Fresno, CA 93711-3708 | 2017-07-08 |
| 1316474026 | Devin Kowalczyk | Psychologist | 1913 N Gateway Blvd, Suite 102, Fresno, CA 93727-1650 | 2017-05-12 |
| 1790153849 | Judy Chang | Psychologist | 4820 N 1st St Ste 103, Fresno, CA 93726-0522 | 2015-09-07 |
| 1215333125 | Robin Fey Sjostrand | Psychologist | 4946 E Yale Ave Ste 103, Fresno, CA 93727-1571 | 2014-11-05 |
| 1689098683 | Julia Schomaker | Psychologist | 5510 N Milburn Ave Apt 215, Fresno, CA 93722-6064 | 2014-02-11 |
| 1912320391 | Leah Leduc | Psychologist | 199 E Cole Ave, Fresno, CA 93720-2034 | 2014-01-21 |
| 1013339985 | Mitchel Casados | Psychologist | 2380 S Sabre Ave, Fresno, CA 93727-8842 | 2014-01-13 |
| 1972939783 | Reshale L Thomas | Psychologist | 2900 Fresno St Ste 108, Fresno, CA 93721 | 2013-09-25 |
| 1831439140 | Larry Neil Ferguson | Psychologist | 642 E Fremont Ave, Fresno, CA 93710-3939 | 2013-02-22 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.