NPIMap

Organization Active NPI

Promesa Behavioral Health

  • Community/Behavioral Health Agency
  • Mendota, CA
National Provider Identifier
1386942316
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
101044 Issued in CA
Legal business name
PROMESA BEHAVIORAL HEALTH
Practice address
211 Smoot Ave
Mendota, CA 93640-2234
Phone
(559) 655-4471
Fax
(559) 655-3226
NPI assigned
Feb 28, 2011
Last updated
Feb 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Authorized official

Name
Lisa Weigant, MANPI 1376716241
Title
Ceo
Phone
(559) 439-5437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 101044 CA Primary

Addresses

Primary practice location

211 Smoot Ave
Mendota, CA 93640-2234

Mailing address

7475 N Palm Ave Ste 107
Fresno, CA 93711-5763
Phone (559) 439-5437

Other identifiers 1

IdentifierTypeStateIssuer
101044MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Promesa Behavioral Health-Enhanced Isfc39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

211 Smoot Ave
Mendota, CA 93640
Phone (559) 655-4471

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298851200000",
    "number": "1386942316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 N PALM AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115763",
            "telephone_number": "559-439-5437",
            "fax_number": "559-439-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SMOOT AVE",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936402234",
            "telephone_number": "559-655-4471",
            "fax_number": "559-655-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMESA BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-28",
        "last_updated": "2011-02-28",
        "status": "A",
        "authorized_official_last_name": "WEIGANT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-439-5437",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "101044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.