CENTRAL CALIFORNIA RECOVERY (NPI# 1295972446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295972446 |
| Entity Type | Organization |
| Organization Name | CENTRAL CALIFORNIA RECOVERY |
| Practice Address |
1204 W Shaw Ave #102 Fresno CA 93711-3706 |
| Practice Telephone | 5596811947 |
| Practice Fax Number | 5598600130 |
| Mailing Telephone | 5596811947 |
| Mailing Fax Number | 5598600130 |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | MR. DALE DEAN WHITE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5596811947 |
| Authorized Official Credential | CADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 106364 | 05 |
| Street Address |
1204 W SHAW AVE #102 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-3706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1760037063 | Armine Petrosyan | Nurse Practitioner | 427 W Beford Ave Suite 103, Fresno, CA 93711 | 2019-08-05 |
| 1912489360 | Shoua Nelson | Nurse Practitioner | 2490 W. Shaw Avenue Suite 101, Fresno, CA 93711 | 2018-09-02 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1407344138 | Aidan Mechem | Behavior Technician | 5140 N. Fruit Avene, Fresno, CA 93711 | 2018-04-27 |
| 1841798840 | Michael Ramos IIi | Behavior Technician | 1690 N Shaw Ave, 102, Fresno, CA 93711 | 2018-01-25 |
| 1962913467 | Dhara Devendrakumar Patel | Pharmacist | 740 West Alluvial Avenue, Suite 101, Fresno, CA 93711 | 2017-10-24 |
| 1588183636 | Bianca Arteaga | Counselor | 7485 N. Palm Ave., Suite 103, Fresno, CA 93711 | 2017-09-10 |
| 1346763158 | Powell Pediatric Dentistry Ingram Partnership | Dentist | 7761 N Ingram Ave, Suite 101, Fresno, CA 93711 | 2017-07-24 |
| 1982124202 | Justine Syera Balbas | Counselor | 2766 W. Celeste Ave., Unit 103, Fresno, CA 93711 | 2017-06-27 |
| Find all providers in zip 93711 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558925909 | Aspire Counseling Services | Clinic/Center | 7125 N Chestnut Ave Ste 104, Fresno, CA 93720-0358 | 2019-04-30 |
| 1437641479 | Spirit of Woman of Ca, Inc. | Clinic/Center | 327 W Belmont Ave, Fresno, CA 93728-2801 | 2018-06-05 |
| 1528599792 | Eminence Healthcare Services, LLC | Clinic/Center | 4250 E Tulare St, Fresno, CA 93702-3037 | 2017-03-21 |
| 1629519871 | Eminence Healthcare Services, LLC | Clinic/Center | 4330 E Garland Ave, Fresno, CA 93726-6102 | 2017-03-20 |
| 1497158737 | Westcare California, Inc | Clinic/Center | 1127 E Escalon, Ahwahnee Middle School, Fresno, CA 93710 | 2014-10-01 |
| 1457606972 | Westcare California Inc. | Clinic/Center | 808 S 10th St, Fresno, CA 93702-3506 | 2012-07-20 |
| 1952673352 | Westcare California | Clinic/Center | 1702 E Bullard Ave Ste 103, Fresno, CA 93710-5800 | 2012-01-31 |
| 1982846986 | Eminence Healthcare Services, LLC | Clinic/Center | 855 W Nielsen Ave, Rooms 1, 2, 3, 5, Fresno, CA 93706-1700 | 2009-04-06 |
| 1700038130 | Eminence Healthcare Services, LLC | Clinic/Center | 4055 N Bryan Ave, Fresno, CA 93723-9426 | 2008-10-16 |
| 1043469539 | Eminence Healthcare, Inc. | Clinic/Center | 6240 W Palo Alto Ave, Rm 201, 301, 801-805, Fresno, CA 93722-2001 | 2008-09-09 |
| 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.