Sean Peng, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95004053 Issued in CA

Practice address

1060 W Sierra Ave # 104
Fresno, CA 93711-2063

Phone

(559) 437-1111

Fax

(559) 437-1118

NPI assigned

Mar 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bio-Behavioral Medical Clinics, IncGroup PAC ID 5395804140, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Bio-Behavioral Medical Clinics, Inc

  • Psychiatry Physician
  • Fresno, CA
  • NPI 1114971314
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512777600000",
    "number": "1265826812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 W SIERRA AVE # 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112063",
            "telephone_number": "559-437-1111",
            "fax_number": "559-437-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W SIERRA AVE # 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112063",
            "telephone_number": "559-437-1111",
            "fax_number": "559-437-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "SEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-22",
        "last_updated": "2017-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95004053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hadara Penaloza
• Maria Penaloza
• Lia Pendergrass
• Lucas James Pendergrass
• Victoria Pendergrass
• Emily Anna Pengilly
• Holly Ann Penley
• Thomas Penman, D.P.M.
• Carol Lee Penn, PH.D.
• Natasha Marie Penn

• Psychiatric/Mental Health Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.