Individual provider Active NPI

Vanessa Rae Verduzco, LMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1205102878
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT97278 Issued in CA
Practice address
142 E Cesar Chavez Blvd
Fresno, CA 93706-3642
Phone
(559) 600-1033
Fax
(559) 600-1101
NPI assigned
Mar 28, 2012
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT97278 CA Primary

Addresses

Primary practice location

142 E Cesar Chavez Blvd
Fresno, CA 93706-3642

Mailing address

142 E California Ave
Fresno, CA 93706-3642
Phone (559) 600-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT97278CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno County CurrentSince Sep 29, 2024 Accepting new patients

Locations

142 E California Ave
Fresno, CA 93706
Phone (559) 600-1033

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1205102878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 E CALIFORNIA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063642",
            "telephone_number": "559-600-1033",
            "fax_number": "559-600-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063642",
            "telephone_number": "559-600-1033",
            "fax_number": "559-600-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUZCO",
        "first_name": "VANESSA",
        "middle_name": "RAE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT97278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.