PRODIGY HEALTHCARE INC. (NPI# 1144775263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144775263 |
| Entity Type | Organization |
| Organization Name | PRODIGY HEALTHCARE INC. |
| Practice Address |
2801 W Adams Ave Fresno CA 93706-9601 |
| Mailing Address |
Po Box 820 Fowler CA 93625-0820 |
| Practice Telephone | 5598929452 |
| Mailing Telephone | 5598929452 |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |
| Authorized Official Name | MR. JAGDIP DHANDA (CEO) |
| Authorized Official Telephone | 5598929452 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609321728 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2311 Sierra St, Kingsburg, CA 93631-1457 | 2016-08-18 |
| 1417402546 | Prodigy Healthcare Inc. | Community/Behavioral Health | 5865 S Clara Ave, Fresno, CA 93706-5805 | 2016-08-18 |
| 1972955227 | Prodigy Healthcare Inc. | Community/Behavioral Health | 1900 18th Ave, Kingsburg, CA 93631-1629 | 2016-07-11 |
| 1659723906 | Prodigy Healthcare Inc. | Community/Behavioral Health | 6041 S Elm Ave, Fresno, CA 93706-6018 | 2016-07-11 |
| 1487164877 | Prodigy Healthcare Inc. | Counselor | 3125 Wright St, Selma, CA 93662-2429 | 2017-10-11 |
| 1508311630 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2888 S Ivy Ave, Fresno, CA 93706-5513 | 2016-08-18 |
| Street Address |
2801 W ADAMS AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93706-9601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295378446 | Caussaundra Maria Dominguez | Counselor | 2772 S Martin Luther King, Fresno, CA 93706 | 2019-10-21 |
| 1881244945 | Aurelio Mendoza | Counselor | 1414 W. Kearney Blvd, Fresno, CA 93706 | 2019-09-19 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1821567538 | Misty Dawn Shepherd | Counselor | 2772 Martin L King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1497224125 | Jose Jimenez | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1023587730 | James John Pokorny IIi | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1932574225 | Brandi Leos | Counselor | 2772 Mlk Jr. Blvd, Fresno, CA 93706 | 2015-12-11 |
| 1174998199 | Jeremiah Hinojosa | Counselor | 2772 S M.l.k. Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| 1538534557 | Megan Mahoney | Counselor | 2772 S Martin Luther King Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| Find all providers in zip 93706 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518687 | Turning Point of Central California, Inc. | Community/Behavioral Health | 3636 N 1st St Ste 112, Fresno, CA 93726-6818 | 2020-11-02 |
| 1114527637 | Clarke-lauren Stevenson Richard | Community/Behavioral Health | 1277 E Loma Linda Ave, Fresno, CA 93720-2668 | 2020-10-26 |
| 1003413600 | Kings View Corporation | Community/Behavioral Health | 7170 N Financial Dr Ste 110, Fresno, CA 93720-2935 | 2020-10-06 |
| 1396360855 | North Star Wellness Center, Inc | Community/Behavioral Health | 6051 N Fresno St Ste 105, Fresno, CA 93710-5280 | 2020-06-10 |
| 1710509377 | Mary Kay Buckley, Psychotherapist Inc | Community/Behavioral Health | 1357 W Shaw Ave Ste 102, Fresno, CA 93711-3619 | 2020-05-17 |
| 1992345797 | Quality Group Homes, Inc. | Community/Behavioral Health | 643 E Sample Ave, Fresno, CA 93710-5428 | 2020-01-09 |
| 1790321412 | Majesty Holistic Health Services | Community/Behavioral Health | 2906 Valiant Elm St, Fresno, TX 77545-8160 | 2019-11-19 |
| 1508410341 | Fresno Youth Care Homes, Inc. | Community/Behavioral Health | 64 E Weldon Ave, Fresno, CA 93704-5956 | 2019-07-30 |
| 1447740063 | Central Star Behavioral Health, Inc. | Community/Behavioral Health | 3433 W Shaw Ave, Fresno, CA 93711-3229 | 2018-05-18 |
| 1114431897 | My Time Recovery, LLC | Community/Behavioral Health | 1107 W Rialto Ave, Fresno, CA 93705-0918 | 2017-11-17 |
| 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.