TRACI RENEE ROA (NPI# 1477105021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477105021 |
| Entity Type | Individual |
| Full Name | TRACI RENEE ROA |
| Practice Address |
2416 W Shaw Ave Ste 114 Fresno CA 93711-3303 |
| Mailing Address |
3433 W Shaw Ave # 112 Fresno CA 93711-3229 |
| Practice Telephone | 5593743990 |
| Mailing Telephone | 5595584051 |
| Enumeration Date | 2019-07-14 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 401 S St, Sacramento, CA 95811 | 9168903016 |
| Street Address |
2416 W SHAW AVE STE 114 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-3303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538423454 | Trina Lisa Villanueva | Counselor | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2012-06-25 |
| 1790399640 | Jessica M Garcia | Licensed Vocational Nurse | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2020-09-08 |
| 1053950576 | Naomi Christina Acuna | Marriage & Family Therapist | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2020-01-01 |
| 1124661863 | Juan Montes | Counselor | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2019-10-25 |
| 1912554940 | Ashley Ann Cuenca | Counselor | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2019-08-23 |
| 1619438769 | Krissy Lee Ghent | Case Manager/Care Coordinator | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2019-03-29 |
| 1922564830 | Michael Joseph Santoya | Case Manager/Care Coordinator | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2019-02-15 |
| 1063997211 | Rosalio Cortez Jr. | Licensed Vocational Nurse | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2018-10-03 |
| 1285118588 | Central Star Behavioral Health, Inc. | Community/Behavioral Health | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2018-09-21 |
| 1114410297 | Ashley Sue Hammer | Counselor | 2416 W Shaw Ave Ste 114, Fresno, CA 93711-3303 | 2018-06-12 |
| Find all providers in the same location | ||||
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710592621 | Marcus Zachary, D.o., P.C. | Counselor | 7111 N Fresno St Ste 200, Fresno, CA 93720-2959 | 2020-09-09 |
| 1871110932 | The Fresno Center | Counselor | 4891 E Kings Canyon Rd, Fresno, CA 93727-3811 | 2020-07-06 |
| 1184240384 | Patsy Joan Perry | Counselor | Quality Family Services - Sample House, 643 E. Sample Avenue, Fresno, CA 93710 | 2020-06-23 |
| 1609414291 | Edgar Torres Becerra | Counselor | 3793 N Polk, Fresno, CA 93722 | 2019-12-15 |
| 1679123723 | Sandy Ounmano | Counselor | 4855 E King Cyn Rd, Fresno, CA 93727-3811 | 2019-09-19 |
| 1609422815 | Alicia Becton | Counselor | 7110 W San Bruno Ave, Fresno, CA 93723-4069 | 2019-08-13 |
| 1053963645 | Stephanie Elizabeth Trevino | Counselor | 5162 E Braly Ave, Fresno, CA 93727-5906 | 2019-07-12 |
| 1386204691 | Giovanni Ismael Arreaga | Counselor | 4411 E Kings Canyon Rd # 310, Fresno, CA 93702-3604 | 2019-06-18 |
| 1205308269 | Kelly Ramirez | Counselor | 496 S. Barton St, Fresno, CA 93702 | 2018-12-31 |
| 1235607409 | Sandra Elizabeth Valle | Counselor | 496 South Barton Avenue, Fresno, CA 93750-0001 | 2018-11-06 |
| Find all providers in FRESNO | ||||
Please comment or provide details below to improve the information on TRACI RENEE ROA.
| 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.