MR. SHANE WILSON (NPI# 1336314392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336314392 |
| Entity Type | Individual |
| Full Name | MR. SHANE WILSON |
| Practice Address |
1470 W Herndon Ave Suite 300 Fresno CA 93711-0552 |
| Practice Telephone | 5592562000 |
| Mailing Telephone | 5592562000 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1982009569 | Shane Michael Wilson | Chiropractor | 938 Wrens Roost Cir, 2, Memphis, TN 38119-0510 | 2014-10-25 |
| 1063742138 | Shane Ray Wilson | Counselor | 2820 Weymouth Way, Norman, OK 73071-7269 | 2010-01-12 |
| 1902440035 | Shane Marcus Wilson | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1437624236 | Shane David Wilson | Nurse Practitioner | 1249 15th St Ste 4000, Huntington, WV 25701-3663 | 2018-10-08 |
| 1477808467 | Shane Charles Wilson | Internal Medicine | 450 E Sigler Ave, Ste A, Memphis, MO 63555-1726 | 2012-07-17 |
| 1245548239 | Shane Wilson | Rehabilitation Practitioner | 741 Rancho Via Dr, Sparks, NV 89434-4051 | 2010-09-23 |
| Street Address |
1470 W HERNDON AVE SUITE 300 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-0552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821179276 | California Psychological Institute | Marriage & Family Therapist | 1470 W Herndon Ave, #300, Fresno, CA 93711-0552 | 2006-10-18 |
| 1669017141 | Tina Xiong | Counselor | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2019-11-08 |
| 1487201935 | Aimee Moore | Counselor | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2019-08-20 |
| 1093208019 | Alejandra Isabel Saldivar Miranda | Marriage & Family Therapist | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2018-06-13 |
| 1386170132 | Lisa James | Marriage & Family Therapist | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2017-05-11 |
| 1700338985 | Lyndsey Chavez | Marriage & Family Therapist | 1470 W Herndon Ave, Suite 300, Fresno, CA 93711-0552 | 2016-11-04 |
| 1932656022 | Adrian Jones | Counselor | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2016-09-06 |
| 1811360530 | Patti Ann Williams | Marriage & Family Therapist | 1470 W Herndon Ave, Suite 300, Fresno, CA 93711-0552 | 2015-11-03 |
| 1952773061 | Anderson Silva | Counselor | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2015-10-28 |
| 1114308889 | Victoria Enriquez | Counselor | 1470 W Herndon Ave, Fresno, CA 93711-0552 | 2015-06-17 |
| Find all providers in the same location | ||||
| 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962012658 | Susan Vue | Counselor | 4855 E King Cyn Rd Ste 105, Fresno, CA 93727-3811 | 2020-08-06 |
| 1104445543 | Chavon Cecily Williams | Counselor | 4006 Redwood Hill Ct, Fresno, TX 77545-8726 | 2020-04-15 |
| 1003444530 | Healing Hopes, Inc. | Counselor | 1960 N Gateway Blvd, Fresno, CA 93727-1604 | 2020-03-30 |
| 1831739853 | Blanca Stephanie Millan | Counselor | 1300 E Shaw Ave Suite 172, Fresno, CA 93710 | 2020-01-07 |
| 1730726407 | Martha Lynn Hosier | Counselor | 1616 W Shaw Ave Ste B2, Fresno, CA 93711-3513 | 2019-12-02 |
| 1598228439 | Bayon B Harris Sr. | Counselor | 4111 W Princeton Ave, Fresno, CA 93722-6810 | 2019-04-08 |
| 1205392008 | Andrew Marshall Davis | Counselor | 320 E Warner Ave, Fresno, CA 93710-3711 | 2019-02-16 |
| 1902375637 | Andrew Arroyo | Counselor | 1925 E Rialto Ave, Fresno, CA 93726-0229 | 2018-11-26 |
| 1265917504 | Romaine Ornelia Desclos | Counselor | 6435 N Palm Ave Ste 103, Fresno, CA 93704-1086 | 2018-10-02 |
| 1508357773 | Armando Mendoza | Counselor | 3138 W Dakota Ave Spc 215, Fresno, CA 93722-4991 | 2018-05-23 |
| 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.