KEONDRE DEJAWN THOMAS (NPI# 1407400856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407400856 |
| Entity Type | Individual |
| Full Name | KEONDRE DEJAWN THOMAS |
| Practice Address |
2772 S Martin Luther King Blvd Fresno CA 93727 |
| Mailing Address |
2772 S Martin Luther King Blvd Fresno CA 93706 |
| Practice Telephone | 5592654800 |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
2772 S MARTIN LUTHER KING BLVD |
| City | FRESNO |
| State | CA |
| Zip Code | 93727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457571077 | Monique Maria Villareal | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2007-04-26 |
| 1194349175 | Arthur Portillo | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2020-06-04 |
| 1770118069 | Armando Enepomuceno Garcia | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2020-03-06 |
| 1700419306 | Maricela Velasquez | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2020-02-21 |
| 1891326229 | Joe Anthony Gaeta | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2020-02-04 |
| 1144868894 | Rosemary Alica Musquez | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2019-12-12 |
| 1518503440 | Michael Jimenez | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2019-11-26 |
| 1053957365 | Roy Perez | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2019-11-21 |
| 1376185033 | Leslie Ann Posey | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706 | 2019-10-15 |
| 1679127955 | Angela M Romero | Counselor | 2772 S Martin Luther King Blvd, Fresno, CA 93706-1225 | 2019-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427524354 | Travis L Minor | Driver | 4573 Kings Canyon Rd, Freso, CA 93727 | 2018-10-18 |
| 1780178921 | Amanda Hernandez | Behavior Technician | 6358 E Mono St, Fresno, CA 93727 | 2018-06-20 |
| 1225533169 | Lindsay Fisher | Marriage & Family Therapist | 4928 E Clinton Way Ste 108, Fresno, CA 93727 | 2018-03-23 |
| 1811351992 | Paulinder Ranu | Pediatrics | 5557 E King Cyn Rd, Fresno, CA 93727 | 2016-04-05 |
| 1851781371 | Sheri Taylor | Social Worker | 2010 N Fine Ave # 105, Fresno, CA 93727 | 2015-02-04 |
| 1770917486 | Elouise Jones-green | Counselor | 4491 E. Mckinley Ave #112, Fresno, CA 93727 | 2013-08-29 |
| 1700227022 | Chee Vang | Counselor | 4855 E Kings Canyon Rd Ste 105, Fresno, CA 93727 | 2013-07-15 |
| 1578839791 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5995 E Kings Canyon Rd, Fresno, CA 93727 | 2012-04-02 |
| 1932411378 | Leticia Ball | Marriage & Family Therapist | 4944 E. Clinton Way, Fresno, CA 93727 | 2010-07-13 |
| 1639308158 | Juanita Sermeno | Counselor | 4944 E. Clinton, Suite 101, Fresno, CA 93727 | 2009-07-06 |
| Find all providers in zip 93727 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1649807694 | Debbie Jeneen Darden | Counselor | 891 W Kearney Blvd, Fresno, CA 93706-2514 | 2020-03-26 |
| 1205466802 | Elizabeth C Esqueda | Counselor | 804 S Parallel Ave, Fresno, CA 93721-2404 | 2020-01-22 |
| 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 |
| 1356994909 | Joaquin Sanchez | Counselor | Quest House 2731 W Olive Ave, Fresno, CA 93728 | 2019-07-23 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1104397348 | Brian K Bradley | Counselor | 2212 N Winery Ave, Fresno, CA 93703-2896 | 2018-12-16 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1831669951 | Ashlee Faith Vasquez | Counselor | 1900 N Gateway Blvd Ste 100, Fresno, CA 93727-1622 | 2018-12-01 |
| 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.