CENTRAL VALLEY WELLNESS CENTER (NPI# 1760940951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760940951 |
| Entity Type | Organization |
| Organization Name | CENTRAL VALLEY WELLNESS CENTER |
| Practice Address |
1478 W Shaw Ave Fresno CA 93711-3607 |
| Practice Telephone | 5594493419 |
| Practice Fax Number | 8773963157 |
| Mailing Telephone | 5594493419 |
| Mailing Fax Number | 8773963157 |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | BRITINY ROSE DILLARD (OFFICE MANAGER) |
| Authorized Official Telephone | 5594493419 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
1478 W SHAW AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-3607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588048995 | Kimberly Herrera | Counselor | 1478 W Shaw Ave, Fresno, CA 93711-3607 | 2015-07-15 |
| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184231508 | Rh Community Builders Lp. | Clinic/Center | 1040 N Pleasant Ave, Fresno, CA 93728-2434 | 2020-09-29 |
| 1629699327 | A New Awakening of The San Joaquin | Clinic/Center | 1121 S Dee Ann Ave, Fresno, CA 93727-0847 | 2020-05-04 |
| 1487193058 | Haskins Residential Care | Clinic/Center | 1037 S Chestnut Ave, Fresno, CA 93702-3907 | 2017-02-15 |
| 1710430418 | St.joseph Counseling Center | Clinic/Center | 5430 N. Palm #108, St. Joseph Counseling Center, Fresno, CA 93704-1900 | 2016-07-28 |
| 1699909812 | County of Fresno | Clinic/Center | 4441 East Kings Canyon Road, Fresno, CA 93702 | 2009-05-04 |
| 1366580540 | Baart Behavioral Health Services, Inc | Clinic/Center | 539 N Van Ness Ave, Fresno, CA 93728-3419 | 2007-02-01 |
| 1013069830 | Fresno County California Clinic | Clinic/Center | 851 Van Ness Ave, Fresno, CA 93721-2637 | 2007-01-18 |
| 1457952756 | Kristin O. Tristao, Ph.d., Psychologist, PC | Clinic/Center | 6700 N 1st St Ste 138, Fresno, CA 93710-3956 | 2020-11-03 |
| 1922607092 | Jus 4 Today | Clinic/Center | 3752 N 1st St, Fresno, CA 93726-5601 | 2020-10-20 |
| 1851925507 | Derric Brown Lcsw, Licensed Clinical Social Worker Inc. | Clinic/Center | 5588 N Palm Ave, Fresno, CA 93704-1913 | 2020-03-02 |
| 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.