NPIMap

Organization Active NPI

Promesa Behavioral Health

  • Community/Behavioral Health Agency
  • Mendota, CA
National Provider Identifier
1073898565
Registry record updated Oct 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
101044 Issued in CA
Legal business name
PROMESA BEHAVIORAL HEALTH
Practice address
1282 Belmont Ave
Mendota, CA 93640-2667
Phone
(559) 655-1993
Fax
(559) 655-0223
NPI assigned
Oct 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2011

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

Authorized official

Name
Lisa Weigant, MA
Title
Ceo
Phone
(559) 439-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 101044 CA Primary

Addresses

Primary practice location

1282 Belmont Ave
Mendota, CA 93640-2667

Mailing address

7475 N Palm Ave Ste 107
Fresno, CA 93711-5763
Phone (559) 439-5437

Other identifiers 1

IdentifierTypeStateIssuer
1044MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Promesa Behavioral Health FCHN39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

1282 Belmont Ave
Mendota, CA 93640
Phone (559) 655-1993

NPI Registry JSON

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

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318636800000",
    "number": "1073898565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 N PALM AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115763",
            "telephone_number": "559-439-5437",
            "fax_number": "559-439-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 BELMONT AVE",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936402667",
            "telephone_number": "559-655-1993",
            "fax_number": "559-655-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMESA BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-15",
        "last_updated": "2011-10-15",
        "status": "A",
        "authorized_official_last_name": "WEIGANT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-439-5437",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "101044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.