Individual provider Active NPI

Celena Thao

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1437822962
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017222 Issued in CA
Practice address
7035 N Maple Ave Ste 102B
Fresno, CA 93720-8026
Phone
(559) 299-2997
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017222 CA Primary

Addresses

Primary practice location

7035 N Maple Ave Ste 102B
Fresno, CA 93720-8026

Mailing address

1127 N Wintergreen Ave
Fresno, CA 93737-9528
Phone (559) 765-8202

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210923000372 CA Practitioner - Nurse Practitioner 6901203611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95017222CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Jan 13, 2023 Accepting new patients
Dominic Dizon, Medical Corporation Past Accepting new patients

Locations

7035 N Maple Ave
Ste 102A
Fresno, CA 93720
Phone (559) 299-2997

7035 N Maple Ave
Ste 102B
Fresno, CA 93720
Phone (559) 299-2997

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2066 E Copper Ave
Ste 102
Fresno, CA 93730
Phone (559) 299-2997

2066 E Copper Ave
Ste 105
Fresno, CA 93730
Phone (559) 299-2997

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 2

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1437822962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 N WINTERGREEN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937379528",
            "telephone_number": "559-765-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 N MAPLE AVE STE 102B",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208026",
            "telephone_number": "559-299-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "CELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.