Individual provider Active NPI

Tejal J Patel, MFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1427488485
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
77631 Issued in CA
Practice address
978 W Alluvial Ave Ste 107
Fresno, CA 93711-5502
Phone
(559) 478-9153
NPI assigned
Nov 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 100043AN CA
Marriage & Family Therapist 106H00000X 77631 CA Primary

Addresses

Primary practice location

978 W Alluvial Ave Ste 107
Fresno, CA 93711-5502

Mailing address

133 Denali
Lake Forest, CA 92630-7632
Phone (559) 493-8200

Other practice location 1

133 Denali
Lake Forest, CA 92630-7632
Phone (559) 478-9153

Other practice location 2

3253 E Shields Ave
Fresno, CA 93726-6904
Phone (559) 298-8231

Other identifiers 1

IdentifierTypeStateIssuer
101044MedicaidCA

Other names 1

  • Tejal Patel Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100043ANCAMDAddiction (Substance Use Disorder) Counselor
77631CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1427488485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 DENALI",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926307632",
            "telephone_number": "559-493-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 W ALLUVIAL AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115502",
            "telephone_number": "559-478-9153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Denali",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926307632",
            "country_code": "US",
            "telephone_number": "559-478-9153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 E Shields Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937266904",
            "country_code": "US",
            "telephone_number": "559-298-8231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TEJAL",
        "middle_name": "J",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "100043AN",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEJAL",
            "last_name": "PATEL",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.