KENNETH UNTALAN (NPI# 1750810206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750810206 |
| Entity Type | Individual |
| Full Name | KENNETH UNTALAN |
| Practice Address |
1620 East Bulldog Lane Fresno CA 93710 |
| Mailing Address |
1906 12th Ave Delano CA 93215-3835 |
| Practice Telephone | 5592784170 |
| Practice Fax Number | 5592788355 |
| Mailing Telephone | 6617039645 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| Street Address |
1620 EAST BULLDOG LANE |
| City | FRESNO |
| State | CA |
| Zip Code | 93710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240384 | Patsy Joan Perry | Counselor | Quality Family Services - Sample House, 643 E. Sample Avenue, Fresno, CA 93710 | 2020-06-23 |
| 1831739853 | Blanca Stephanie Millan | Counselor | 1300 E Shaw Ave Suite 172, Fresno, CA 93710 | 2020-01-07 |
| 1679115737 | Abel Luis Flores | Physical Therapy Assistant | 5556 N Fresno St, 5555 N Fresno St, Fresno, CA 93710 | 2019-10-10 |
| 1316408933 | Simranjit Kaur Mann | Behavioral Analyst | 5180 North Primitivo Way Appt #363, Fresno, CA 93710 | 2019-03-27 |
| 1093274169 | Aleajndra Bedolla Alcantar | Behavior Technician | 1320 East Shaw Ave, #110, Fresno, CA 93710 | 2019-03-18 |
| 1790244960 | Alondra Martinez | Behavior Technician | 1320 East Shaw Ave #110, Fresno, CA 93710 | 2019-03-18 |
| 1235698622 | Irma Joselyn Castro | Behavior Technician | 1320 East Shaw Ave # 110, Fresno, CA 93710 | 2019-03-15 |
| 1619433711 | Beacon Dental Group | Dentist | 6099 N. First Ste Ste 102, Fresno, CA 93710 | 2019-02-13 |
| 1265909394 | Pathana Phonesy | Behavior Technician | 5363 N. Fresno St., Suite 105, Fresno, CA 93710 | 2018-10-26 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| Find all providers in zip 93710 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526672 | Chandni T Patel | Student in an Organized Health Care Education/Training Program | 9715 N Willey Ct, Fresno, CA 93720-5418 | 2020-07-29 |
| 1649892514 | Jasdeep Brar | Student in an Organized Health Care Education/Training Program | 4409 E Inyo St. Unit A, Fresno, CA 93702-2977 | 2020-05-13 |
| 1396364048 | Dessere Givertz | Student in an Organized Health Care Education/Training Program | 10155 N Edgewood Dr, Fresno, CA 93720-3423 | 2020-04-13 |
| 1366061129 | Ariel Lok Yen Leung | Student in an Organized Health Care Education/Training Program | 1313 East Herndon Ave, St 105, Fresno, CA 93720 | 2020-04-13 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1669001632 | Hunza Chaudhry | Student in an Organized Health Care Education/Training Program | 155 N Fresno St Ste 307, Fresno, CA 93701-2302 | 2020-04-02 |
| 1720616345 | Veronica Moffitt | Student in an Organized Health Care Education/Training Program | 6536 N Wheeler Ave, Fresno, CA 93722-3007 | 2020-03-30 |
| 1225682701 | Mariah Isabel Negrete | Student in an Organized Health Care Education/Training Program | 5503 W Pinedale Ave, Fresno, CA 93722-2348 | 2019-08-01 |
| 1174184543 | Keschia Matthews | Student in an Organized Health Care Education/Training Program | 2118 Beacon Light Ln, Fresno, TX 77545-7089 | 2019-06-25 |
| 1710545884 | Tanica Eboni Washington | Student in an Organized Health Care Education/Training Program | 4151 N Blythe Ave Apt 132, Fresno, CA 93722-6376 | 2019-06-03 |
| Find all providers in FRESNO | ||||
Please comment or provide details below to improve the information on KENNETH UNTALAN.
| 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.