Juan Alfredo Bedolla

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95005969 Issued in CA

Practice address

1350 O St Ste 302
Fresno, CA 93721-1828

Phone

(559) 369-4625

Fax

(559) 369-7259

NPI assigned

May 14, 2007

Last updated

Aug 16, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Juan Alfredo Bedolla Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juan.bedolla.p1@direct.omnifamilyhealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Power Mental Health Services Inc

  • Psychiatry Physician
  • Fresno, CA
  • NPI 1962272799
  Medicare reassignment NPD Authorized official
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Buttonwillow, CA
  • NPI 1700891660
  Medicare reassignment NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1770399669
  NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Hanford, CA
  • NPI 1912418310
  NPD

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786838400000",
    "number": "1386850998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25042",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937295042",
            "telephone_number": "559-369-4625",
            "fax_number": "559-693-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 O ST STE 302",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211828",
            "telephone_number": "559-369-4625",
            "fax_number": "559-369-7259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 W Sierra Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937112063",
            "country_code": "US",
            "telephone_number": "559-721-5656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4411 E Kings Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-453-1008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26135 Mureau Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Calabasas",
            "state": "CA",
            "postal_code": "913023125",
            "country_code": "US",
            "telephone_number": "844-496-9160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 O St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211828",
            "country_code": "US",
            "telephone_number": "559-369-4625",
            "fax_number": "559-369-7259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Mineral King Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932916237",
            "country_code": "US",
            "telephone_number": "559-624-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4411 N Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937262538",
            "country_code": "US",
            "telephone_number": "559-248-1548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDOLLA",
        "first_name": "JUAN",
        "middle_name": "ALFREDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2026-08-16",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95059739",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95005969",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95059739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "BEDOLLA",
            "middle_name": "ALFREDO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristopher Bedi, D.O.
• Aleajndra Bedolla Alcantar
• Diana Bedolla
• Eliza Samantha Bedolla
• Jose Leonel Bedolla, B.A. (HISTORY)
• Madai Bedolla
• Vanessa Bedolla
• Armen Hovhannes Bedrosian, M.D.
• Erica Lynn Bedsted, NP
• Bee Lees Catering LLC

• Psychiatric/Mental Health Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.