JACK PORTER (NPI# 1780734574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780734574 |
| Entity Type | Individual |
| Full Name | JACK PORTER |
| Practice Address |
3707 E Shields Ave Fresno CA 93726-7029 |
| Mailing Address |
970 Makenna St Lemoore CA 93245-4502 |
| Practice Telephone | 5592299040 |
| Practice Fax Number | 5592299060 |
| Mailing Telephone | 5599240663 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467573626 | Jack Clark Porter | Dentist | 1919 Malvern Ave, Hot Springs, AR 71901-7753 | 2007-04-03 |
| 1508874991 | Jack Porter | Psychologist | 1205 Manoa Rd, Wynnewood, PA 19096 | 2006-08-03 |
| Street Address |
3707 E SHIELDS AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93726-7029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285715789 | Marc D. Lasher | General Practice | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2006-10-18 |
| 1215544838 | Christina Marie Fierro Gonzalez | Licensed Vocational Nurse | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2020-09-28 |
| 1255947321 | Kozi Scott | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2020-09-23 |
| 1457976409 | Claudia Ramirez | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2020-06-15 |
| 1285265819 | Edith Gonzalez | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2020-02-02 |
| 1275182651 | Lupe Rana Ornelas | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2019-09-09 |
| 1881253177 | Maria Hilda Davila | Licensed Vocational Nurse | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2019-06-10 |
| 1700444023 | Barbara Ann Robinson | Licensed Vocational Nurse | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2019-06-01 |
| 1548733363 | Brittany Garber | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2019-01-03 |
| 1518439868 | Guadalupe Olivares | Counselor | 3707 E Shields Ave, Fresno, CA 93726-7029 | 2018-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528520814 | Tania Grijalva Miranda | Behavior Technician | 4910 E. Ashland Ave, Fresno, CA 93726 | 2019-04-04 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1013481100 | Jill A Perricone | Respiratory Therapist, Registered | 4785 N First St, Fresno, CA 93726 | 2019-01-11 |
| 1285108399 | Leann Lokelani Benton | Respiratory Therapist, Registered | 4785 N. First St, Fresno, CA 93726 | 2019-01-11 |
| 1548745912 | Alina Gonzalez | Counselor | 4440 N. First St., Fresno, CA 93726 | 2018-10-01 |
| 1336622067 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 3751 E Shields Ave, Fresno, CA 93726 | 2018-09-10 |
| 1730676206 | Joanne K Groves | Counselor | 3636 N. First Street, St. 123, Fresno, CA 93726 | 2018-04-19 |
| 1356865679 | Fresno Mental Psychological Health Services, P.C. | Clinic/Center | 4021 N Fresno Street, Ste. 101, Fresno, CA 93726 | 2017-07-28 |
| 1205358819 | Jetinder Singh Ghag | Counselor | 3636 N.first St # 135 and 154, Fresno, CA 93726 | 2017-07-14 |
| 1164897328 | Karam Um Dds Inc | Dentist | 4747 N. First St. #174, Fresno, CA 93726 | 2015-12-14 |
| Find all providers in zip 93726 | ||||
| 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.