Organization Active NPI

Signature Providers Nursing Corp

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1265263065
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SIGNATURE PROVIDERS NURSING CORP
Practice address
1690 W Shaw Ave Ste 220
Fresno, CA 93711-3519
Phone
(888) 848-4364
Fax
(833) 218-8844
NPI assigned
Aug 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Mark Aganya, PMHNPNPI 1366270621
Title
Ceo
Phone
(888) 848-4364

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1690 W Shaw Ave Ste 220
Fresno, CA 93711-3519

Mailing address

PO Box 392
Coalinga, CA 93210-0392
Phone (888) 848-4364

Other identifiers 1

IdentifierTypeStateIssuer
1366270621MedicaidCA

National Provider Directory

National Provider Directory

Locations

3415 S Sepulveda Blvd
#11
Los Angeles, CA 90034

1401 21st St
#5723
Sacramento, CA 95811

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1265263065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932100392",
            "telephone_number": "888-848-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 W SHAW AVE STE 220",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113519",
            "telephone_number": "888-848-4364",
            "fax_number": "833-218-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE PROVIDERS NURSING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "AGANYA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-848-4364",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366270621",
            "state": "CA"
        }
    ],
    "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 Jun 19, 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.

Verify at the official NPI Registry.