Medmark1

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

B3084739 Issued in CA

Legal business name

MEDMARK1

Doing business as

same

Practice address

1310 M St
Same
Fresno, CA 93721-1808

Phone

(559) 264-2700

NPI assigned

Mar 19, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Lynn Rivas

Title

Counselor

Phone

(559) 264-2700

Specialties & licenses 1

Addresses

Other names 1

• same Doing business as

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268956800000",
    "number": "1316261373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 M ST",
            "address_2": "SAME",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211808",
            "telephone_number": "559-264-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 M ST",
            "address_2": "SAME",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211808",
            "telephone_number": "559-264-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDMARK1",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "559-264-2700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "B3084739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "same",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurel J Medlock
• Medmark Treatment Center Fresno
• Medmark Treatment Centers - Fresno West, Inc.
• Medmark Treatment Centers-Fresno East, Inc.
• Medmark Treatment Centers, Inc.
• Elida Medrano-Camarillo
• Eleanor Medrano-Colon
• Ana Medrano, M.S., CCC-SLP
• Chaylyn Raquelle Medrano, RBT
• Jessica A Medrano

• Case Management Agency in Fresno, CA
• Providers in Fresno, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.