Active NPI
Tammy Andrade-de la Isla
- Social Worker
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCSW119397
- Practice address
- 2560 W Shaw LN Ste 104
Fresno, CA 93711-2777 - Phone
- (559) 443-4800
- NPI assigned
- Dec 9, 2020
- Last updated
- Dec 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW91940 | CA | |
| Social Worker | 104100000X | ASW91940 | CA | |
| Social Worker | 104100000X | LCSW119397 | CA | Primary |
Addresses
Primary practice location
2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Mailing address
2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone (559) 443-4800
Other practice location 1
4939 E Yale Ave
Fresno, CA 93727-1523
Phone (559) 443-4800
Other practice location 2
2020 High St Ste E
Selma, CA 93662-3518
Phone (559) 443-4800
Other names 1
- Tammy Andrade
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW91940 | CA | MD | Social Worker |
| LCSW119397 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Mental Health | Current | Accepting new patients |
| Fresno County Superintendent of Schools | Current | Accepting new patients | |
| Fresno County Superintendent of Schools | Current | Accepting new patients | |
| Fresno County Superintendent of Schools | Past | Accepting new patients |
Locations
2440 Tulare St
Ste 200
Fresno, CA 93721
Phone (559) 265-3089
2560 W Shaw Ln
Ste 104
Fresno, CA 93711
Phone (559) 431-1086
4939 E Yale Ave
Fresno, CA 93727
Phone (559) 443-4820
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
2020 High St
Ste E
Selma, CA 93662
Phone (559) 443-8000
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 4
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.
-
- Mental Health Counselor
- San Jose, CA
- NPI 1154994846
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fresno, CA
- NPI 1235624768
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fresno, CA
- NPI 1467042408
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Selma, CA
- NPI 1114549110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1255937892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 W SHAW LN STE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937112777",
"telephone_number": "559-443-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 W SHAW LN STE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937112777",
"telephone_number": "559-443-4800"
}
],
"practiceLocations": [
{
"address_1": "4939 E Yale Ave",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937271523",
"country_code": "US",
"telephone_number": "559-443-4800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2020 High St Ste E",
"address_purpose": "LOCATION",
"city": "Selma",
"state": "CA",
"postal_code": "936623518",
"country_code": "US",
"telephone_number": "559-443-4800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDRADE-DE LA ISLA",
"first_name": "TAMMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-09",
"last_updated": "2023-12-11",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW91940",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "ASW91940",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCSW119397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TAMMY",
"last_name": "ANDRADE",
"code": "1",
"type": "Former Name"
}
]
}
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 Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.