Active NPI
Elizabeth Noel Camacho
- Community Health Worker
- Fresno, CA
National Provider Identifier
1114770880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 496 S Barton Ave
Fresno, CA 93702-2985 - Phone
- (559) 860-4422
- NPI assigned
- Apr 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
496 S Barton Ave
Fresno, CA 93702-2985
Mailing address
3433 W Shaw Ave # 108
Fresno, CA 93711-3229
Phone (559) 558-4051
NPI Registry JSON
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1114770880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3433 W SHAW AVE # 108",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113229",
"telephone_number": "559-558-4051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 S BARTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937022985",
"telephone_number": "559-860-4422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "ELIZABETH",
"middle_name": "NOEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-10",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.