NPIMap

Organization Active NPI

Prodigy Healthcare Non Profit

  • Adolescent and Children Mental Health Clinic/Center
  • Fowler, CA
National Provider Identifier
1265158661
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
PRODIGY HEALTHCARE NON PROFIT
Practice address
311 E Merced St
Fowler, CA 93625-2316
Phone
(559) 892-9452
NPI assigned
Oct 17, 2022
Last updated
Oct 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Mr. Jagdip DhandaNPI 1194960005
Title
Ceo
Phone
(559) 892-9452

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

311 E Merced St
Fowler, CA 93625-2316

Mailing address

311 E Merced St
Fowler, CA 93625-2316
Phone (559) 892-9452

National Provider Directory

National Provider Directory

Locations

311 E Merced St
Fowler, CA 93625
Phone (555) 892-9452

Practitioners & affiliated clinicians

Practitioners 137

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1265158661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E MERCED ST",
            "city": "FOWLER",
            "state": "CA",
            "postal_code": "936252316",
            "telephone_number": "559-892-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E MERCED ST",
            "city": "FOWLER",
            "state": "CA",
            "postal_code": "936252316",
            "telephone_number": "559-892-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY HEALTHCARE NON PROFIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "DHANDA",
        "authorized_official_first_name": "JAGDIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-892-9452",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fowler, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.