PHYLLIS RODRIGUEZ (NPI# 1619370004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619370004 |
| Entity Type | Individual |
| Full Name | PHYLLIS RODRIGUEZ |
| Practice Address |
496 S Barton Ave Fresno CA 93702-2985 |
| Mailing Address |
3420 Winter Way Madera CA 93637-5956 |
| Practice Telephone | 5593743990 |
| Mailing Telephone | 5592753555 |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2019-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT 35583 | CA | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 301 E 13th St Ste D, Merced, CA 953416211 | 2093861096 | |
| 3147 N Millbrook Ave, Fresno, CA 937031425 | 5596006760 |
| Street Address |
496 S BARTON AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93702-2985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698051 | Areli Quinilla | Counselor | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-10-27 |
| 1447859889 | Luis Omar Rodriguez | Counselor | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-10-17 |
| 1225644297 | Guadalupe Gil | Licensed Vocational Nurse | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-09-16 |
| 1790390714 | Kiranjeet Bhinder | Licensed Vocational Nurse | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-09-15 |
| 1184238909 | Luis Alberto Suarez-lopez | Counselor | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-08-31 |
| 1225649197 | Domonique E Soto | Counselor | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-08-13 |
| 1497372247 | Ezereli Ledesma Gomez | Marriage & Family Therapist | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-06-28 |
| 1992321384 | Saylene A Servin | Licensed Vocational Nurse | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-06-22 |
| 1346862158 | Jason Alan Cavataio | Licensed Vocational Nurse | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-05-14 |
| 1194353441 | Noris Martinez | Counselor | 496 S Barton Ave, Fresno, CA 93702-2985 | 2020-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644543 | Brandy Eugena Dickey | Licensed Vocational Nurse | 496 S. Barton St., Fresno, CA 93702 | 2019-02-06 |
| 1205308269 | Kelly Ramirez | Counselor | 496 S. Barton St, Fresno, CA 93702 | 2018-12-31 |
| 1518437995 | Kimberlin Ann Klein | Licensed Vocational Nurse | 4411 E Kings Canyon Rd #319, Fresno, CA 93702 | 2018-11-28 |
| 1932677317 | Simone Danielle Cato | Counselor | 496 S Barton St, Fresno, CA 93702 | 2018-11-05 |
| 1558879841 | Mekdes Elizabeth Yilma | Marriage & Family Therapist | 4144 E. Kings Canyon Rd., Fresno, CA 93702 | 2018-01-20 |
| 1831647874 | Rick Foster | Registered Nurse | 441 East Kings Canyon Ave, Fresno, CA 93702 | 2016-09-20 |
| 1770935140 | Diana L. Eaglin | Registered Nurse | 4409 E. Inyo St., Modular A, Fresno, CA 93702 | 2016-07-08 |
| 1700257243 | Elizabeth Lee | Registered Nurse | 4411 E.kings Canyon Rd, Fresno, CA 93702 | 2015-10-09 |
| 1548657299 | Brandi Lynn Rieux | Counselor | 496 S. Barton Ave, Fresno, CA 93702 | 2015-04-21 |
| 1891069548 | Tamara Taylor | Case Manager/Care Coordinator | 890 S. Tenth Street, Fresno, CA 93702 | 2012-02-28 |
| Find all providers in zip 93702 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649570458 | Kimberly Hudspeth | Licensed Psychiatric Technician | 1148 W Gettysburg Ave, Fresno, CA 93705-0933 | 2010-10-26 |
| 1871748657 | Steven Ralph Colwell | Licensed Psychiatric Technician | 637 W Hammond Ave, Fresno, CA 93728-2200 | 2008-11-20 |
| 1356404602 | Joseph Exnicious Jules | Licensed Psychiatric Technician | 1312 E Garland Ave, Fresno, CA 93704-4938 | 2006-12-18 |
| 1871100248 | Tanveer Hans | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-29 |
| 1366069577 | Ulysses Ruvalcaba | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-03 |
| 1750908141 | Brooke Annette Denham | Licensed Psychiatric Technician | 4441 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-01 |
| 1376178509 | Michelle Mendez | Licensed Psychiatric Technician | 1235 E St, Fresno, CA 93706-2024 | 2020-03-09 |
| 1801426630 | Shaylee Maxfield | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd # 319, Fresno, CA 93702-3604 | 2020-01-21 |
| 1740828094 | Eric Okafor | Licensed Psychiatric Technician | 496 S Barton Ave, Fresno, CA 93702-2985 | 2019-12-18 |
| 1609411677 | Anthony Jauregui | Licensed Psychiatric Technician | 496 S Barton Ave, Fresno, CA 93702-2985 | 2019-11-13 |
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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.