STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM (NPI# 1720299175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720299175 |
| Entity Type | Organization |
| Organization Name | STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM |
| Other Organization Name | STATE HEALTH CARE DUAL DIAGNOSIS PROGRAM |
| Practice Address |
1145 W Hedges Ave Suite B Fresno CA 93728-1219 |
| Mailing Address |
19300 Rinaldi St Suite 8270 Northridge CA 91326-1651 |
| Practice Telephone | 3106289512 |
| Practice Fax Number | 8188044047 |
| Mailing Telephone | 3106289512 |
| Mailing Fax Number | 8188044047 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. EDNA MILLER (PRESIDENT) |
| Authorized Official Telephone | 3106289512 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
100056BP | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DMC PROVIDER NUMBER | 1068 | 01 |
| Other Name | Type Code |
|---|---|
| State Health Care Dual Diagnosis Program | Doing Business As Name - Organization |
| Street Address |
1145 W HEDGES AVE SUITE B |
| City | FRESNO |
| State | CA |
| Zip Code | 93728-1219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689884595 | State Health Care Dual Diagnosis | Clinic/Center | 1145 W Hedges Ave, Fresno, CA 93728-1219 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994909 | Joaquin Sanchez | Counselor | Quest House 2731 W Olive Ave, Fresno, CA 93728 | 2019-07-23 |
| 1750873717 | Focus Forward | Case Management | 732 N. Van Ness Ave, Fresno, CA 93728 | 2018-06-05 |
| 1811167927 | Rita Elizabeth Stevenson | Counselor | 1027 N Van Ness Ave, Fresno, CA 93728 | 2008-03-04 |
| 1578784153 | Ann B. White | Psychologist | 938 N. Van Ness Avenue, Fresno, CA 93728 | 2007-05-01 |
| 1891912283 | B & B Management Inc. | Dentist | 1215 N. Del Mar Ave., Fresno, CA 93728 | 2007-04-19 |
| 1285858696 | Geoffrey Landon Smith | Marriage & Family Therapist | 1055 N. Van Ness, Suite I, Fresno, CA 93728 | 2007-04-13 |
| 1225152077 | Melva Robinson | Licensed Vocational Nurse | 539 N Van Ness, Fresno, CA 93728 | 2007-03-19 |
| 1508902131 | Lauro Samson So | Dentist | 1436 E Olive Ave, Fresno, CA 93728 | 2007-01-30 |
| 1922467083 | Karie Jean Follis | Licensed Vocational Nurse | 539 N Van Ness Ave, Fresno, CA 93728 | 2016-02-17 |
| 1013216969 | Elena Soza | Counselor | 2731 W Olive Ave, Fresno, CA 93728 | 2011-03-17 |
| Find all providers in zip 93728 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558925909 | Aspire Counseling Services | Clinic/Center | 7125 N Chestnut Ave Ste 104, Fresno, CA 93720-0358 | 2019-04-30 |
| 1437641479 | Spirit of Woman of Ca, Inc. | Clinic/Center | 327 W Belmont Ave, Fresno, CA 93728-2801 | 2018-06-05 |
| 1528599792 | Eminence Healthcare Services, LLC | Clinic/Center | 4250 E Tulare St, Fresno, CA 93702-3037 | 2017-03-21 |
| 1629519871 | Eminence Healthcare Services, LLC | Clinic/Center | 4330 E Garland Ave, Fresno, CA 93726-6102 | 2017-03-20 |
| 1497158737 | Westcare California, Inc | Clinic/Center | 1127 E Escalon, Ahwahnee Middle School, Fresno, CA 93710 | 2014-10-01 |
| 1457606972 | Westcare California Inc. | Clinic/Center | 808 S 10th St, Fresno, CA 93702-3506 | 2012-07-20 |
| 1952673352 | Westcare California | Clinic/Center | 1702 E Bullard Ave Ste 103, Fresno, CA 93710-5800 | 2012-01-31 |
| 1982846986 | Eminence Healthcare Services, LLC | Clinic/Center | 855 W Nielsen Ave, Rooms 1, 2, 3, 5, Fresno, CA 93706-1700 | 2009-04-06 |
| 1295972446 | Central California Recovery | Clinic/Center | 1204 W Shaw Ave #102, Fresno, CA 93711-3706 | 2009-01-09 |
| 1700038130 | Eminence Healthcare Services, LLC | Clinic/Center | 4055 N Bryan Ave, Fresno, CA 93723-9426 | 2008-10-16 |
| 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.