DEPARTMENT OF BEHAVIORAL HEALTH (NPI# 1841612587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841612587 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF BEHAVIORAL HEALTH |
| Practice Address |
1221 Fulton Mall Fresno CA 93721-1915 |
| Mailing Address |
Po Box 11867 Fresno CA 93775-1867 |
| Practice Telephone | 5596003550 |
| Mailing Telephone | 5596003550 |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |
| Authorized Official Name | DAINNA LYNN DRIVER (LVN) |
| Authorized Official Telephone | 5596003550 |
| Is Organization Subpart | Y |
| Parent Organization Name | COUNTY OF FRESNO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | VN242638 | CA | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700923968 | Department of Behavioral Health | Case Management | 2164 Hackamore Pl, Riverside, CA 92506-4616 | 2007-01-30 |
| 1801318316 | Department of Behavioral Health | Social Worker | 2025 E Dakota Ave, Fresno, CA 93726-4804 | 2017-07-17 |
| 1871628750 | Department of Behavioral Health | Health Maintenance Organization | 805 E Mountain View St, Barstow, CA 92311-3033 | 2007-02-22 |
| 1629137575 | Department of Behavioral Health | Social Worker | 4441 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2006-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEPARTMENT OF BEHAVIORAL HEALTH | 4417 E Inyo Ave Bldg 333, Fresno, CA 93702-2977 |
| System for Award Management (SAM) Entities | DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES | 1220 Bank St, Richmond, VA 23219-3645 |
| Street Address |
1221 FULTON MALL |
| City | FRESNO |
| State | CA |
| Zip Code | 93721-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396711784 | Eleana Marie Phillips | Physical Therapist | 1221 Fulton Mall, Cms - Ccs, Fresno, CA 93721-1915 | 2006-02-24 |
| 1427471747 | Heather Woo | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2014-01-22 |
| 1851714281 | Dianna Lynn Driver | Licensed Vocational Nurse | 1221 Fulton Mall, Fic - 1st Floor, Fresno, CA 93721-1915 | 2014-01-21 |
| 1457783003 | Corina Mozelle Martinez | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2013-08-06 |
| 1750729323 | William Joseph Godizano | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2013-06-05 |
| 1144667981 | Aquina Lajewel Baulkman | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2013-06-03 |
| 1932546678 | Elizabeth Trujillo Cruz | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2013-06-03 |
| 1265771703 | Evelyn Lotter | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2013-02-04 |
| 1366795478 | Pamela Senatore | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2012-10-26 |
| 1922358365 | Liliyan Honarchian | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93775-1867 | 2012-09-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1619521929 | Kepler Education Incorporation | Local Education Agency (LEA) | 1462 Broadway St., Fresno, CA 93721 | 2019-07-25 |
| 1588156434 | Micha Ramirez | Case Manager/Care Coordinator | 2140 Merced St., Fresno, CA 93721 | 2018-06-05 |
| 1649798992 | Nadia C Martinez | Licensed Vocational Nurse | 1310 M. Street, Fresno, CA 93721 | 2017-09-07 |
| 1538604251 | Be Together Home Care LLC | In Home Supportive Care | 2014 Tulare St Ste 605, Fresno, CA 93721 | 2017-01-04 |
| 1124426705 | Central California Faculty Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2554 Merced Street, Fresno, CA 93721 | 2014-12-12 |
| 1427455336 | University Medical Supply | Durable Medical Equipment & Medical Supplies | 2554 Merced St, Fresno, CA 93721 | 2014-11-21 |
| 1154723542 | Ryan Gil | Physical Therapist | 1350 O St Ste 201, Fresno, CA 93721 | 2014-09-17 |
| 1831526250 | Tiffany Marie Gonzalez | Counselor | 2409 Mered St #106, Fresno, CA 93721 | 2013-09-30 |
| 1972939783 | Reshale L Thomas | Psychologist | 2900 Fresno St Ste 108, Fresno, CA 93721 | 2013-09-25 |
| Find all providers in zip 93721 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376067439 | Alacar. Inc | Intermediate Care Facility, Mental Illness | 4640 E Kaviland Ave, Fresno, CA 93725-1632 | 2017-07-31 |
| 1063564169 | Noia Residential Services Inc | Intermediate Care Facility, Mental Illness | 1236 E Gettysburg, Fresno, CA 93704 | 2007-01-17 |
| 1225124993 | Shuman-shepherd Inc. | Intermediate Care Facility, Mental Illness | 6074 N 9th St, Fresno, CA 93710-5816 | 2006-10-04 |
| 1770679417 | Shepherd Family Home | Intermediate Care Facility, Mental Illness | 8893 N Sierra Vista Ave, Fresno, CA 93720-3948 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
| 1497386569 | M&s Guesthomes, Inc. | Intermediate Care Facility, Mental Illness | 2424 W Glencrest Ave, Anaheim, CA 92801-3224 | 2020-01-28 |
| 1346711504 | Cedacal, LLC. | Intermediate Care Facility, Mental Illness | 5663 Cedarglen Dr, Azusa, CA 91702-5007 | 2018-12-16 |
| 1396213302 | Amazing Grace Oasis II | Intermediate Care Facility, Mental Illness | 8708 Bridgeport Ave, Hesperia, CA 92344-5562 | 2018-11-07 |
| 1972081651 | Oc Care Centers, Inc. | Intermediate Care Facility, Mental Illness | 127 N Queensbury St, Anaheim, CA 92806-3814 | 2018-08-03 |
| 1659858868 | Athina Kamar | Intermediate Care Facility, Mental Illness | 5826 Jumilla Ave, Woodland Hills, CA 91367-5604 | 2018-07-20 |
| 1447758024 | Crestwood Behavioral Health Inc | Intermediate Care Facility, Mental Illness | 450 Stanyan St Fl 5, San Francisco, CA 94117-1019 | 2018-01-29 |
| 1912358904 | American Helath Services | Intermediate Care Facility, Mental Illness | 1524 W 227th St Apt 1, Torrance, CA 90501-4917 | 2016-06-30 |
| 1639547896 | Arcaida Home Care & Staffing | Intermediate Care Facility, Mental Illness | 1090 E Cypress Ave, Suite B, Redding, CA 96002-1163 | 2015-09-04 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
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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.