MISTY DAWN SHEPHERD (NPI# 1821567538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821567538 |
| Entity Type | Individual |
| Full Name | MISTY DAWN SHEPHERD |
| Practice Address |
2772 Martin L King Blvd Fresno CA 93706 |
| Mailing Address |
2772 S Martin L King Jr Blvd Fresno CA 93706-5345 |
| Practice Telephone | 5592654800 |
| Mailing Telephone | 5592654800 |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
2772 MARTIN L KING BLVD |
| City | FRESNO |
| State | CA |
| Zip Code | 93706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548730518 | Eric Galeana | Counselor | 2772 Martin L King Blvd, Fresno, CA 93706 | 2018-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295378446 | Caussaundra Maria Dominguez | Counselor | 2772 S Martin Luther King, Fresno, CA 93706 | 2019-10-21 |
| 1881244945 | Aurelio Mendoza | Counselor | 1414 W. Kearney Blvd, Fresno, CA 93706 | 2019-09-19 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1497224125 | Jose Jimenez | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1023587730 | James John Pokorny IIi | Counselor | 2772 Martin L. King Blvd, Fresno, CA 93706 | 2018-11-26 |
| 1932574225 | Brandi Leos | Counselor | 2772 Mlk Jr. Blvd, Fresno, CA 93706 | 2015-12-11 |
| 1174998199 | Jeremiah Hinojosa | Counselor | 2772 S M.l.k. Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| 1538534557 | Megan Mahoney | Counselor | 2772 S Martin Luther King Jr Blvd, Fresno, CA 93706 | 2015-12-02 |
| 1326413493 | Tracy Herrera | Counselor | 2772 S. Martin Luther King Boul., Fresno, CA 93706 | 2015-12-01 |
| Find all providers in zip 93706 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1649807694 | Debbie Jeneen Darden | Counselor | 891 W Kearney Blvd, Fresno, CA 93706-2514 | 2020-03-26 |
| 1205466802 | Elizabeth C Esqueda | Counselor | 804 S Parallel Ave, Fresno, CA 93721-2404 | 2020-01-22 |
| 1295378446 | Caussaundra Maria Dominguez | Counselor | 2772 S Martin Luther King, Fresno, CA 93706 | 2019-10-21 |
| 1881244945 | Aurelio Mendoza | Counselor | 1414 W. Kearney Blvd, Fresno, CA 93706 | 2019-09-19 |
| 1356994909 | Joaquin Sanchez | Counselor | Quest House 2731 W Olive Ave, Fresno, CA 93728 | 2019-07-23 |
| 1003374539 | Jasmine Elizabeth Flores | Counselor | 2772 S Martin Luther King Junior Blvd, Fresno, CA 93706 | 2019-03-04 |
| 1104397348 | Brian K Bradley | Counselor | 2212 N Winery Ave, Fresno, CA 93703-2896 | 2018-12-16 |
| 1063982049 | Bruno Sivongxay | Counselor | 2772 South Martin L King Jr Blvd, Fresno, CA 93706 | 2018-12-03 |
| 1831669951 | Ashlee Faith Vasquez | Counselor | 1900 N Gateway Blvd Ste 100, Fresno, CA 93727-1622 | 2018-12-01 |
| 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.