SEAN PENG (NPI# 1265826812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265826812 |
| Entity Type | Individual |
| Full Name | SEAN PENG |
| Credential | NP |
| Practice Address |
1060 W Sierra Ave # 104 Fresno CA 93711-2063 |
| Mailing Address |
1060 W Sierra Ave # 105 Fresno CA 93711-2063 |
| Practice Telephone | 5594371111 |
| Practice Fax Number | 5594371118 |
| Mailing Telephone | 5594371111 |
| Mailing Fax Number | 5594371118 |
| Enumeration Date | 2015-03-22 |
| Last Update Date | 2017-12-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95004053 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1060 W SIERRA AVE # 104 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-2063 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1225016447 | James Wong | Nurse Practitioner | 2615 E Clinton Ave, Fresno, CA 93703 | 2006-01-06 |
| Find all providers in FRESNO | ||||
Please comment or provide details below to improve the information on SEAN PENG.
| 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.