Individual provider Active NPI

Angie Jenkins

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1326284779
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2550 W Clinton Ave
Fresno, CA 93705-4206
Phone
(559) 264-7521
Fax
(559) 441-0293
NPI assigned
Jan 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

2550 W Clinton Ave
Fresno, CA 93705-4206

Mailing address

2550 W Clinton Ave
Fresno, CA 93705-4206
Phone (559) 264-7521

Other practice location 1

4944 E Clinton Way
Suite 101
Fresno, CA 93727-1527
Phone (559) 251-4800 ext. 297

Other practice location 2

611 E Belmont Ave
Fresno, CA 93701-1502
Phone (559) 237-3420 ext. 20322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1326284779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054206",
            "telephone_number": "559-264-7521",
            "fax_number": "559-441-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 W CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937054206",
            "telephone_number": "559-264-7521",
            "fax_number": "559-441-0293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4944 E Clinton Way",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271527",
            "country_code": "US",
            "telephone_number": "559-251-4800 x297",
            "fax_number": "559-453-7827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 E Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937011502",
            "country_code": "US",
            "telephone_number": "559-237-3420 x20322",
            "fax_number": "559-485-7244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "ANGIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 28, 2021; 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.