PRODIGY HEALTHCARE INC. (NPI# 1487164877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487164877 |
| Entity Type | Organization |
| Organization Name | PRODIGY HEALTHCARE INC. |
| Practice Address |
3125 Wright St Selma CA 93662-2429 |
| Mailing Address |
311 E Merced St Fowler CA 93625-2316 |
| Practice Telephone | 5598929452 |
| Mailing Telephone | 5598929452 |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2018-03-17 |
| 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 | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2269 Sylvia St, Selma, CA 936623436 | 5598929452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609321728 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2311 Sierra St, Kingsburg, CA 93631-1457 | 2016-08-18 |
| 1144775263 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2801 W Adams Ave, Fresno, CA 93706-9601 | 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 |
| 1508311630 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2888 S Ivy Ave, Fresno, CA 93706-5513 | 2016-08-18 |
| Street Address |
3125 WRIGHT ST |
| City | SELMA |
| State | CA |
| Zip Code | 93662-2429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831242494 | Eminence Healthcare, Inc. | Clinic/Center | 3125 Wright St, Rm 410,907a,1508,library,archive,cowboy Central,busi..., Selma, CA 93662-2429 | 2007-01-18 |
| 1124536313 | William Mestas | Specialist/Technologist | 3125 Wright St, Selma, CA 93662-2429 | 2018-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215416839 | United Health Centers of The San Joaquin Valley | Clinic/Center | 2705 S Highland Ave, Selma, CA 93662 | 2018-08-14 |
| 1265930598 | Sharon King | Home Health Aide | 6296 E. Mt. View Ave, Selma, CA 93662 | 2018-02-01 |
| 1174972095 | Ranjit Kaur | Nurse's Aide | 1805 Aspen Street, Selma, CA 93662 | 2016-06-10 |
| 1548629223 | Navjot Sihota | Dentist | 14409 South Dewolf Ave, Selma, CA 93662 | 2016-02-23 |
| 1437482676 | K.w. Kim, A Professional Corp | Internal Medicine | 1205 Evergreen Street, Selma, CA 93662 | 2009-09-04 |
| 1467638536 | Lungren Chiropractic Center Inc | Chiropractor | 1850 Floral Ave, Selma, CA 93662 | 2008-01-18 |
| 1164634333 | Gerald Lynn Thomas | Pharmacist | 2640 Floral Ave, Selma, CA 93662 | 2007-05-03 |
| 1306989652 | Donald Henry Jacobsen | Dentist | 1221 Rose Ave, Selma, CA 93662 | 2007-02-15 |
| 1306988746 | California Occupational Medicine Practice Inc | Preventive Medicine | 1142 Rose Avenue, Selma, CA 93662 | 2007-02-13 |
| 1962548925 | Courtney Joseph Moore | Physical Therapist | 2251 Country Club Lane, Selma, CA 93662 | 2007-01-29 |
| Find all providers in zip 93662 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053682815 | Michael Na Daniels | Counselor | 105 Winter Ct, Selma, NC 27576-2189 | 2012-01-25 |
| 1598034118 | Lagreta Williams Cameron | Counselor | 1420a S Pollock St, Selma, NC 27576-3404 | 2011-12-28 |
| 1043485014 | James Adam Lassiter | Counselor | 602 S Sumner St, Selma, NC 27576-2947 | 2008-04-29 |
| 1760494785 | Wanda W Walton | Counselor | 1202 Richmond Street, Selma, VA 24474 | 2006-08-12 |
| 1275952574 | Laura Ann Caldarera | Counselor | 1420a S Pollock St, Selma, NC 27576-3404 | 2014-04-15 |
| 1932535135 | Tiffani Mccormick | Counselor | 200 S Pollock St, Selma, NC 27576-3062 | 2013-09-19 |
| 1639374655 | Linda Chewning Nelson | Counselor | 1101 River Rd, Selma, NC 27576-3611 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1538760871 | Ky Washington | Counselor | 1625 Sweetwater Rd # C1, National City, CA 91950-7647 | 2020-11-03 |
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1548869266 | Yama Totakhail | Counselor | 915 Bryant St # 94103, San Francisco, CA 94103-4514 | 2020-10-23 |
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1285233155 | Alaric Fairchild | Counselor | 1400 N Johnson Ave Ste 1011400n, El Cajon, CA 92020-1650 | 2020-10-21 |
| 1487253571 | Roxanne Rene Coito | Counselor | 1919 Apple St # D, Oceanside, CA 92054-4425 | 2020-10-20 |
| 1255939732 | Diana Palencia | Counselor | 44459 10th St W, Lancaster, CA 93534-3324 | 2020-10-15 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| Find all providers with the same taxonomy | ||||
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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.