Individual provider Active NPI

Cheyenne Marie Pallares, MSW

  • Social Worker
  • Fresno, CA
National Provider Identifier
1063085322
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
128972 Issued in CA
Practice address
2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone
(559) 443-4800
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW102367 CA
Clinical Social Worker 1041C0700X 102367 CA
Social Worker 104100000X 128972 CA Primary

Addresses

Primary practice location

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777

Mailing address

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone (559) 443-4800

Other practice location 1

2020 High St Ste E
Selma, CA 93662-3518
Phone (559) 896-1007

Other practice location 2

4939 E Yale Ave
Fresno, CA 93727-1523
Phone (559) 443-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250530002446 CA Practitioner - Clinical Social Worker 4981113156 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW102367CAMDMental Health Counselor
102367CAMDClinical Social Worker
128972CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno County Superintendent of Schools CurrentSince Nov 12, 2023 Accepting new patients
Fresno County Superintendent of Schools CurrentSince Apr 1, 2024 Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince Apr 25, 2025 Accepting new patients
Fresno County Superintendent of Schools PastSince May 17, 2020 Accepting new patients

Locations

2560 W Shaw Ln
Ste 104
Fresno, CA 93711
Phone (559) 431-1086

4939 E Yale Ave
Fresno, CA 93727
Phone (559) 443-4820

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

2020 High St
Ste E
Selma, CA 93662
Phone (559) 443-8000

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1063085322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 High St Ste E",
            "address_purpose": "LOCATION",
            "city": "Selma",
            "state": "CA",
            "postal_code": "936623518",
            "country_code": "US",
            "telephone_number": "559-896-1007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4939 E Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271523",
            "country_code": "US",
            "telephone_number": "559-443-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALLARES",
        "first_name": "CHEYENNE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW102367",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102367",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "128972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.