Individual provider Active NPI

Vanessa Lopez

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1386230340
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125603 Issued in CA
Practice address
1717 S Chestnut Ave
Fresno, CA 93702-4709
Phone
(559) 453-8050
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 125603 CA Primary

Addresses

Primary practice location

1717 S Chestnut Ave
Fresno, CA 93702-4709

Mailing address

1717 S Chestnut Ave
Fresno, CA 93702-4709

Other practice location 1

4812 E Butler Ave
Fresno, CA 93727-5014
Phone (559) 453-8076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno Pacific University Dba Pacific Counseling Center Marriage & Family Therapist CurrentSince Dec 1, 2024 Accepting new patients

Locations

1717 S Chestnut Ave
#14
Fresno, CA 93702
Phone (559) 453-8073

4812 E Butler Ave
Fresno, CA 93727
Phone (559) 453-8050

1717 S Chestnut Ave
Fresno, CA 93702
Phone (559) 453-8050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1386230340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S CHESTNUT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937024709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S CHESTNUT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937024709",
            "telephone_number": "559-453-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4812 E Butler Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937275014",
            "country_code": "US",
            "telephone_number": "559-453-8076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.