Active NPI
Marco Pantoja Jr.
- Clinical Psychologist
- Corcoran, CA
National Provider Identifier
1497034854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 36426
- Practice address
- 900 Quebec Ave
Corcoran, CA 93212-9715 - Phone
- (559) 747-3984
- Fax
- (559) 992-7100
- NPI assigned
- Aug 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 36426 | CA | Primary |
| Counselor | 101Y00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
900 Quebec Ave
Corcoran, CA 93212-9715
Mailing address
1740 E Academy Ave
Tulare, CA 93274-3104
Phone (559) 608-2118
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36426 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768348800000",
"number": "1497034854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 E ACADEMY AVE",
"city": "TULARE",
"state": "CA",
"postal_code": "932743104",
"telephone_number": "559-608-2118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 QUEBEC AVE",
"city": "CORCORAN",
"state": "CA",
"postal_code": "932129715",
"telephone_number": "559-747-3984",
"fax_number": "559-992-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANTOJA",
"first_name": "MARCO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-16",
"last_updated": "2026-01-14",
"certification_date": "2026-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "36426",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corcoran, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.