Individual provider Active NPI

Rene Ricardo Huerta Sr., LMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1417334228
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129815 Issued in CA
Practice address
2416 W Shaw Ave Ste 114
Fresno, CA 93711-3303
Phone
(559) 974-7644
NPI assigned
Apr 30, 2015
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 85515 CA
Marriage & Family Therapist 106H00000X 125322 CA
Marriage & Family Therapist 106H00000X 129815 CA Primary

Addresses

Primary practice location

2416 W Shaw Ave Ste 114
Fresno, CA 93711-3303

Mailing address

2416 W Shaw Ave Ste 114
Fresno, CA 93711-3303
Phone (559) 974-7644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619002546 CA Practitioner - Marriage and Family Therapist 3274076146 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85515CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindcure, Inc CurrentSince Jul 1, 2023 Accepting new patients
Achievements Unlimited Clinical Psychology Services, Inc. CurrentSince Jun 15, 2024 Accepting new patients
Fresno Family Therapy Marriage & Family Therapist Past Accepting new patients
Central Star Behavioral Health, Inc. PastSince Apr 25, 2021 Accepting new patients

Locations

106 Pollasky Ave
Ste D
Clovis, CA 93612
Phone (559) 203-3775

7575 N Cedar Ave
Ste 102
Fresno, CA 93720
Phone (559) 203-3775

512 N Court St
Visalia, CA 93291
Phone (559) 203-3775

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1417334228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 W SHAW AVE STE 114",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113303",
            "telephone_number": "559-974-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 W SHAW AVE STE 114",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113303",
            "telephone_number": "559-974-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTA",
        "first_name": "RENE",
        "middle_name": "RICARDO",
        "name_suffix": "Sr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85515",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125322",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.