Eliza Samantha Bedolla

Key facts

NPI

1003762964

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

1401 Fulton St Ste 200
Fresno, CA 93721-1646

Phone

(559) 578-5298

NPI assigned

Mar 4, 2026

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 4, 2026.

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1003762964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 E BULLDOG LN APT 203",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107329",
            "telephone_number": "559-872-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FULTON ST STE 200",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211646",
            "telephone_number": "559-578-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDOLLA",
        "first_name": "ELIZA",
        "middle_name": "SAMANTHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

• Alicia Becton
• Victoria Marie Bedell, MD
• Kristopher Bedi, D.O.
• Aleajndra Bedolla Alcantar
• Diana Bedolla
• Jose Leonel Bedolla, B.A. (HISTORY)
• Juan Alfredo Bedolla
• Madai Bedolla
• Vanessa Bedolla
• Armen Hovhannes Bedrosian, M.D.

All providers in Fresno, CA · Behavior Technician in California