MB Dual Diagnosis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

179679 Issued in CA

Legal business name

MB DUAL DIAGNOSIS

Practice address

302 E Fountain Way
Fresno, CA 93704-4619

Phone

(559) 352-2714

NPI assigned

Dec 18, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Isaac Becerra Jr., B.S

Title

C.E.O

Phone

(559) 352-2714

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1396929923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4782 N 9TH ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260912",
            "telephone_number": "559-352-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E FOUNTAIN WAY",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937044619",
            "telephone_number": "559-352-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MB DUAL DIAGNOSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "BECERRA",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "559-352-2714",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "B.S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "179679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Mazariegos, M.D.
• Abigail Anne Mazon, DDS
• Dorothy K. Mazurek, RN, CCM
• Patrick Mazzei, D.D.S.
• Lisa M Mazzola, OTRL
• Christopher James McAdams
• Renee Michelle McAdoo, RN
• Jade Alexandra McAfee, CERTIFIED DOULA
• Leslie Louise McAleenan
• Bruce Earl McAlister, L.C.S.W

• Mental Health Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.