Individual provider Active NPI

Jesus Gamboa

  • Counselor
  • Fresno, CA
National Provider Identifier
1427768076
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
784 W. Holland Ave.
Fresno, CA 93726-9372
Phone
(559) 538-1230
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

784 W. Holland Ave.
Fresno, CA 93726-9372

Mailing address

3520 E Shields Ave Ste 102
Fresno, CA 93726-6923
Phone (559) 538-1230

Other practice location 1

1555 Santa Clara St
Fresno, CA 93726-9372
Phone (559) 538-1230

Other practice location 2

532 S Trinity St
Fresno, CA 93706-1874
Phone (559) 538-1230

Other practice location 3

3039 N Blackstone Ave
Fresno, CA 93703-1015
Phone (559) 538-1230

Other practice location 4

1828 Broadway St
Fresno, CA 93721-1002
Phone (559) 538-1230

Other practice location 5

4041 Plaza Dr W
Fresno, CA 93702-1342
Phone (559) 538-1230

Other practice location 6

205 N Blackstone Ave
Fresno, CA 93701-1939
Phone (559) 538-1230

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

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Recovery, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1427768076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 E SHIELDS AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266923",
            "telephone_number": "559-538-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 W. HOLLAND AVE.",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937269372",
            "telephone_number": "559-538-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Santa Clara St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937269372",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "532 S Trinity St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937061874",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3039 N Blackstone Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031015",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1828 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211002",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4041 Plaza Dr W",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937021342",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N Blackstone Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937011939",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "JESUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "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 Dec 5, 2022; 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.