Individual provider Active NPI

Roy L Buford

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1407163777
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C055710518 Issued in CA
Practice address
1310 M St
Fresno, CA 93721-1808
Phone
(559) 264-2700
Fax
(559) 264-2767
NPI assigned
Sep 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C055710518 CA Primary

Addresses

Primary practice location

1310 M St
Fresno, CA 93721-1808

Mailing address

114 E Shaw Ave Ste 210
Fresno, CA 93710-7621
Phone (559) 221-8100

Other practice location 1

114 E Shaw Ave Ste 210
Fresno, CA 93710-7621
Phone (559) 221-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C055710518CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1407163777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E SHAW AVE STE 210",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107621",
            "telephone_number": "559-221-8100",
            "fax_number": "559-221-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 M ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211808",
            "telephone_number": "559-264-2700",
            "fax_number": "559-264-2767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 E Shaw Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937107621",
            "country_code": "US",
            "telephone_number": "559-221-8100",
            "fax_number": "559-221-8101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUFORD",
        "first_name": "ROY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C055710518",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 10, 2024; 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.