DR. MICHAEL FOX ANTRIM (NPI# 1336130053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336130053 |
Entity Type | Individual |
Full Name | DR. MICHAEL FOX ANTRIM |
Credential | PH.D. |
Practice Address |
1357 W Shaw Ave Suite 104 Fresno CA 93711-3602 |
Practice Telephone | 5592225221 |
Practice Fax Number | 5592223939 |
Mailing Telephone | 5592225221 |
Mailing Fax Number | 5592223939 |
Enumeration Date | 2005-11-02 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY7647 | CA | Behavioral Health & Social Service Providers |
Street Address |
1357 W SHAW AVE SUITE 104 |
City | FRESNO |
State | CA |
Zip Code | 93711-3602 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336143981 | Vibrantcare Outpatient Rehabilitation of California Inc | Clinic/Center | 1357 W Shaw Ave, Suite 101, Fresno, CA 93711-3618 | 2005-06-10 |
1578723805 | Jeoung P Park | Psychologist | 1357 W Shaw Ave, Ste 104, Fresno, CA 93711-3619 | 2008-06-10 |
1811166002 | Tracy Jean Jolly | Physical Therapist | 1357 W Shaw Ave, Suite 101, Fresno, CA 93711-3602 | 2008-02-21 |
1740492586 | Foxley & Herbert Medical Corporation | Obstetrics & Gynecology | 1357 W Shaw Ave, Ste.103, Fresno, CA 93711-3602 | 2007-05-04 |
1851431977 | David Lindley Hellwig | Psychologist | 1357 W Shaw Ave, Suite 104, Fresno, CA 93711-3618 | 2007-02-07 |
1063522100 | Robert Timothy Butler II | Chiropractor | 1357 W Shaw Ave, 103, Fresno, CA 93711-3602 | 2006-08-30 |
1083695969 | Mary Margaret Post | Social Worker | 1357 W Shaw Ave, Suite 104, Fresno, CA 93711-3602 | 2005-11-08 |
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 | 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.