SHAWNCAI FULSOM (NPI# 1477109502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477109502 |
| Entity Type | Individual |
| Full Name | SHAWNCAI FULSOM |
| Practice Address |
1690 W Shaw Ave Ste 102 Fresno CA 93711-3518 |
| Mailing Address |
21600 Oxnard St Ste 1800 Woodland Hills CA 91367-7807 |
| Practice Telephone | 5592555900 |
| Mailing Telephone | 8183452345 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
1690 W SHAW AVE STE 102 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-3518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659881886 | Angelina Duarte | Assistant Behavior Analyst | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2017-10-02 |
| 1730711672 | Ashley Medina | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2020-02-09 |
| 1053941500 | Cymone Annise Tyson | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2020-01-23 |
| 1437797131 | Alanna Wiley | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-12-13 |
| 1699310235 | Sabrie Jackson | Behavioral Analyst | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-11-07 |
| 1235774829 | Caresse Latreece Wilson-cotter | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-11-07 |
| 1598309205 | Kyana Elisa Rendon | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-11-05 |
| 1932743606 | Antonio Samora | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-11-05 |
| 1760026702 | Katherinn M Hernanez | Behavior Technician | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-11-02 |
| 1932743341 | Brittney Ann Hernandez | Behavioral Analyst | 1690 W Shaw Ave Ste 102, Fresno, CA 93711-3518 | 2019-10-30 |
| 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 | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972446 | Kellyn Hartsfield | Behavior Technician | 3252 W Barstow Ave, Fresno, CA 93711-2606 | 2020-11-06 |
| 1649871419 | Jay Galarza | Behavior Technician | 5490 N. Salinas Ave., Apt. L133, Fresno, CA 93722 | 2020-11-06 |
| 1568079622 | Thuan Lam | Behavior Technician | 3138 W Dakota Ave Spc 106, Fresno, CA 93722-4979 | 2020-09-23 |
| 1306450671 | Andrea Elise Calvillo-garcia | Behavior Technician | 4423 N Emerson Ave, Fresno, CA 93705-1204 | 2020-09-03 |
| 1467064774 | Bianca Silva | Behavior Technician | 4757 N Woodrow Ave Unit 117, Fresno, CA 93726-1725 | 2020-08-18 |
| 1669083358 | Victoria Marie Sanchez | Behavior Technician | 5755 W Mesa Ave, Fresno, CA 93722-3179 | 2020-08-14 |
| 1205454022 | Mya Renee Nazario | Behavior Technician | 8540 N Sierra Vista Ave, Fresno, CA 93720-3915 | 2020-07-08 |
| 1548886112 | Kassandra Yetiem Cordova Del Valle | Behavior Technician | 3520 E Kerckhoff Ave, Fresno, CA 93702-2710 | 2020-06-19 |
| 1649894593 | Jessica Ybarra | Behavior Technician | 2547 W Shaw Ave Ste 113, Fresno, CA 93711-3321 | 2020-06-05 |
| 1518592153 | Sarvenaz Pahlavan | Behavior Technician | 5168 N Blythe Ave Ste 103, Fresno, CA 93722-6478 | 2020-03-04 |
| 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.