PRODIGY HEALTHCARE INC. (NPI# 1972955227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972955227 |
| Entity Type | Organization |
| Organization Name | PRODIGY HEALTHCARE INC. |
| Practice Address |
1900 18th Ave Kingsburg CA 93631-1629 |
| Mailing Address |
Po Box 820 Fowler CA 93625-0820 |
| Practice Telephone | 5598929452 |
| Mailing Telephone | 5598929452 |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |
| Authorized Official Name | MR. JAGDIP DHANDA (CEO) |
| Authorized Official Telephone | 5598929452 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609321728 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2311 Sierra St, Kingsburg, CA 93631-1457 | 2016-08-18 |
| 1144775263 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2801 W Adams Ave, Fresno, CA 93706-9601 | 2016-08-18 |
| 1417402546 | Prodigy Healthcare Inc. | Community/Behavioral Health | 5865 S Clara Ave, Fresno, CA 93706-5805 | 2016-08-18 |
| 1659723906 | Prodigy Healthcare Inc. | Community/Behavioral Health | 6041 S Elm Ave, Fresno, CA 93706-6018 | 2016-07-11 |
| 1487164877 | Prodigy Healthcare Inc. | Counselor | 3125 Wright St, Selma, CA 93662-2429 | 2017-10-11 |
| 1508311630 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2888 S Ivy Ave, Fresno, CA 93706-5513 | 2016-08-18 |
| Street Address |
1900 18TH AVE |
| City | KINGSBURG |
| State | CA |
| Zip Code | 93631-1629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336799790 | Eric Lane Silvius | Technician | 2340 18th Avenue, Kingsburg, CA 93631 | 2019-09-18 |
| 1356855647 | Henry Pereschica | Interpreter | 221 Mariposa St, Kingsburg, CA 93631 | 2017-11-22 |
| 1386796423 | Tri County Family Medical Clinic | Family Medicine | 2400 Sierra Street, Kingsburg, CA 93631 | 2007-01-17 |
| 1558665877 | Robert B Stillwagon | Physical Therapist | 392 Sierra St, Kingsburg, CA 93631 | 2010-12-29 |
| 1104074400 | Kingsburg Family Dental | Dentist | 1064 Lewis St, Kingsburg, CA 93631 | 2008-08-29 |
| 1447303268 | Gregory A Dunford | Family Medicine | 2400 Sierra Street, Kingsburg, CA 93631 | 2007-01-18 |
| 1154474971 | Bruce A Trevino | Family Medicine | 2400 Sierra Street, Kingsburg, CA 93631 | 2007-01-18 |
| 1790792356 | Model Drug Inc | Pharmacy | 1506 Draper St, Kingsburg, CA 93631 | 2006-08-03 |
| 1699760090 | Shaunna Shortes | Family Medicine | Po Box 472, Kingsburg, CA 93631-0472 | 2005-09-13 |
| 1386830214 | Kingsburg Joint Union Elementary | Local Education Agency (LEA) | 1310 Stroud Ave, Kingsburg, CA 93631-1000 | 2007-09-25 |
| Find all providers in zip 93631 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609321728 | Prodigy Healthcare Inc. | Community/Behavioral Health | 2311 Sierra St, Kingsburg, CA 93631-1457 | 2016-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881861 | Griselda Tuchan Pineda Marriage and Family Therapist Inc | Community/Behavioral Health | 2820 S Vermont Ave Ste 16, Los Angeles, CA 90007-2291 | 2020-11-04 |
| 1013518687 | Turning Point of Central California, Inc. | Community/Behavioral Health | 3636 N 1st St Ste 112, Fresno, CA 93726-6818 | 2020-11-02 |
| 1588264113 | Licensed Clinical Social Worker Community Alliance PC | Community/Behavioral Health | 301 S 23rd St, Richmond, CA 94804-2807 | 2020-11-01 |
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1114527637 | Clarke-lauren Stevenson Richard | Community/Behavioral Health | 1277 E Loma Linda Ave, Fresno, CA 93720-2668 | 2020-10-26 |
| 1891395232 | Jacqulyn Danielle Rios | Community/Behavioral Health | 4604 W Douglas Ave Apt 103, Visalia, CA 93291-4195 | 2020-10-26 |
| 1346849213 | Greystone Behavioral Health Nursing Inc | Community/Behavioral Health | 231 E Alessandro Blvd Ste A438, Riverside, CA 92508-5084 | 2020-10-22 |
| 1376142216 | Melissa Reyes Aguilar | Community/Behavioral Health | 2248 S Cochran Ave, Los Angeles, CA 90016-1218 | 2020-10-21 |
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1326647686 | Sierra Child & Family Services | Community/Behavioral Health | 564 Mountain Ranch Rd Ste 5, San Andreas, CA 95249-9782 | 2020-10-19 |
| Find all providers with the same taxonomy | ||||
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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.