Active NPI
Desert River Psychology, Inc.
- Psychologist
- Fresno, CA
National Provider Identifier
1356925325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- DESERT RIVER PSYCHOLOGY, INC.
- Practice address
- 4781 E Gettysburg Ave #101
Fresno, CA 93726-1814 - Phone
- (559) 472-8375
- Fax
- (888) 466-8290
- NPI assigned
- May 6, 2021
- Last updated
- May 6, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alexia Baca Morgan
- Title
- Psychologist/President
- Phone
- (559) 472-8375
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | Primary |
Addresses
Primary practice location
4781 E Gettysburg Ave #101
Fresno, CA 93726-1814
Mailing address
4781 E Gettysburg Ave #101
Fresno, CA 93726-1814
Phone (559) 472-8375
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5593142 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
4781 E Gettysburg Ave
#101
Fresno, CA 93726
Phone (559) 472-8375
4781 E Gettysburg Ave
Ste 101
Fresno, CA 93726
Phone (559) 472-8375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620259200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620259200000",
"number": "1356925325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4781 E GETTYSBURG AVE #101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937261814",
"telephone_number": "559-472-8375",
"fax_number": "888-466-8290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4781 E GETTYSBURG AVE #101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937261814",
"telephone_number": "559-472-8375",
"fax_number": "888-466-8290"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DESERT RIVER PSYCHOLOGY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-06",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A",
"authorized_official_last_name": "BACA MORGAN",
"authorized_official_first_name": "ALEXIA",
"authorized_official_title_or_position": "PSYCHOLOGIST/PRESIDENT",
"authorized_official_telephone_number": "559-472-8375"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5593142",
"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 May 6, 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.