NPIMap

Organization Active NPI

House Psychiatric Clinic, Inc.

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1235314246
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2OA7888 Issued in CA
Legal business name
HOUSE PSYCHIATRIC CLINIC, INC.
Practice address
1322 E Shaw Ave
Suite 410
Fresno, CA 93710-0000
Phone
(559) 226-1316
Fax
(559) 226-1315
NPI assigned
Jan 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Dr. Matthew Benijah Judson House, D.O.NPI 1134192842
Title
President/Ceo
Phone
(559) 226-1316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 2OA7888 CA Primary
Adult Mental Health Clinic/Center 261QM0850X 2OA7888 CA

Addresses

Primary practice location

1322 E Shaw Ave
Suite 410
Fresno, CA 93710-0000

Mailing address

1322 E Shaw Ave
Suite 410
Fresno, CA 93710-0000
Phone (559) 226-1316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080417000688 CA Part B Supplier - Clinic/Group Practice 4587742432 Receives reassigned benefits from 17 practitioners
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Locations

1322 E Shaw Ave
Ste 410
Fresno, CA 93710
Phone (559) 226-1316

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1235314246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 E SHAW AVE",
            "address_2": "SUITE 410",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937100000",
            "telephone_number": "559-226-1316",
            "fax_number": "559-226-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 E SHAW AVE",
            "address_2": "SUITE 410",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937100000",
            "telephone_number": "559-226-1316",
            "fax_number": "559-226-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE PSYCHIATRIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "HOUSE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "BENIJAH JUDSON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "559-226-1316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "2OA7888",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "2OA7888",
            "primary": false
        }
    ],
    "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 Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.