FADY BOULES (NPI# 1639541022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639541022 |
| Entity Type | Individual |
| Full Name | FADY BOULES |
| Practice Address |
2002 N Fine Ave Unit 101 Fresno CA 93727-1511 |
| Mailing Address |
18672 Florida St Ste 201c Huntington Beach CA 92648-6088 |
| Practice Telephone | 9517220801 |
| Mailing Telephone | 9512680745 |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2020-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
95003306 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95003306 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRIVER LIC | D4304887 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 133 W Main St, El Cajon, CA 920203315 | 6194010404 | |
| 18672 Florida St Ste 201c, Huntington Beach, CA 926486088 | 7149160499 | |
| 1880 E Washington St, Colton, CA 923244621 | 9094230234 | |
| 2010 N Fine Ave # 105, Fresno, CA 937271558 | 5594576770 | |
| 302 Fresno St Ste 106, Fresno, CA 937063641 | 5534576770 | |
| 3451 W Shaw Ave Ste 101, Fresno, CA 937113242 | 5594576770 | |
| 3451 W Shaw Ave Ste 102, Fresno, CA 937113242 | 5594576770 | |
| 55497 Van Buren St, Thermal, CA 922749412 | 7603994526 | |
| 69175 Ramon Rd Ste A, Cathedral City, CA 922343344 | 7603216776 | |
| 901 Dove St Ste 145, Newport Beach, CA 926603034 | 9499551088 |
| Street Address |
2002 N FINE AVE UNIT 101 |
| City | FRESNO |
| State | CA |
| Zip Code | 93727-1511 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265826812 | Sean Peng | Nurse Practitioner | 1060 W Sierra Ave # 104, Fresno, CA 93711-2063 | 2015-03-22 |
| 1205867173 | John Thomas Bachman | Nurse Practitioner | 7131 N 11th St, Fresno, CA 93720-3375 | 2006-07-06 |
| 1871598623 | Susan Davin | Nurse Practitioner | 1322 E Shaw Ave Ste 410, Fresno, CA 93710-7904 | 2005-06-17 |
| 1063416873 | Cecilia S. Salazar | Nurse Practitioner | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2005-06-09 |
| 1528539681 | Andrew Douglas Monasterio | Nurse Practitioner | 1322 E Shaw Ave Ste 410, Fresno, CA 93710-7904 | 2018-12-16 |
| 1922507037 | Medard Sison | Nurse Practitioner | 4441 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2018-02-03 |
| 1639549447 | Emily Samuel | Nurse Practitioner | 2740 S Elm Ave, Fresno, CA 93706-5435 | 2015-10-06 |
| 1871846691 | Vandana Anilkumar Ganatra | Nurse Practitioner | 4441 E Kings Canyon Rd, Fresno County Department of Behavioral Health, Fresno, CA 93702-3604 | 2012-10-17 |
| 1598024697 | Barbara L Woodward | Nurse Practitioner | 4411 E Kings Canyon Rd, Fresno, CA 93702 | 2012-05-09 |
| 1891877387 | Diana Maria Radakovic | Nurse Practitioner | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2006-10-20 |
| 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.