Individual provider Active NPI

John Maxwell III

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1487146205
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
145643 Issued in CA
Practice address
2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone
(559) 443-4800
NPI assigned
Jun 6, 2018
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 145643 CA Primary

Addresses

Primary practice location

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777

Mailing address

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone (559) 443-4800

Other practice location 1

4939 E Yale Ave
Fresno, CA 93727-1523
Phone (559) 483-4800

Other practice location 2

2020 High St Ste S
Selma, CA 93662-3518
Phone (559) 443-4800

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
I20251106002522 CA Practitioner - Marriage and Family Therapist 6204326424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5820 Owens Dr
Pleasanton, CA 94588-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
145643CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Sep 22, 2025 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Sep 22, 2025 Accepting new patients
Fresno County Superintendent of Schools CurrentSince Jun 2, 2024 Accepting new patients
Fresno County Superintendent of Schools CurrentSince Jun 2, 2024 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4939 E Yale Ave
Fresno, CA 93727
Phone (559) 443-4820

4785 N 1st St
Fresno, CA 93726
Phone (559) 448-4555

2560 W Shaw Ln
Ste 104
Fresno, CA 93711
Phone (559) 431-1086

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

2440 Tulare St
Ste 200
Fresno, CA 93721
Phone (559) 265-3089

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 5

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1487146205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4939 E Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271523",
            "country_code": "US",
            "telephone_number": "559-483-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 High St Ste S",
            "address_purpose": "LOCATION",
            "city": "Selma",
            "state": "CA",
            "postal_code": "936623518",
            "country_code": "US",
            "telephone_number": "559-443-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL III",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.