Active NPI
Robert Ray Ross
- Addiction (Substance Use Disorder) Counselor
- Fresno, CA
National Provider Identifier
1154207520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- SUDRC18508
- Practice address
- 2772 S Martin Luther King Boulevard
Fresno, CA 93706 - Phone
- (559) 614-6627
- NPI assigned
- Aug 12, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | SUDRC18508 | CA | Primary |
Addresses
Primary practice location
2772 S Martin Luther King Boulevard
Fresno, CA 93706
Mailing address
2772 S Martin Luther King Boulevard
Fresno, CA 93706
Phone (559) 614-6627
Other practice location 1
2772 S M.L.K Blvd
fresno, CA 93706
Phone (559) 265-4800 ext. 20178
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SUDRC18508 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755216000000",
"number": "1154207520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2772 S MARTIN LUTHER KING BOULEVARD",
"city": "FRESNO",
"state": "CA",
"postal_code": "93706",
"telephone_number": "559-614-6627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2772 S MARTIN LUTHER KING BOULEVARD",
"city": "FRESNO",
"state": "CA",
"postal_code": "93706",
"telephone_number": "559-614-6627"
}
],
"practiceLocations": [
{
"address_1": "2772 S M.L.K Blvd",
"address_purpose": "LOCATION",
"city": "fresno",
"state": "CA",
"postal_code": "93706",
"country_code": "US",
"telephone_number": "559-265-4800 x20178",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSS",
"first_name": "ROBERT",
"middle_name": "RAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-12",
"last_updated": "2025-08-15",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "SUDRC18508",
"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 Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.