Organization Active NPI

Desert River Psychology, Inc.

  • Psychologist
  • Fresno, CA
National Provider Identifier
1356925325
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
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, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
5593142MedicaidCA

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.