Active NPI
Ezereli Ledesma Gomez
- Marriage & Family Therapist
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 496 S Barton Ave
Fresno, CA 93702-2985 - Phone
- (559) 860-4422
- NPI assigned
- Jun 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
496 S Barton Ave
Fresno, CA 93702-2985
Mailing address
3433 W Shaw Ave Ste 102
Fresno, CA 93711-3229
Phone (559) 360-9195
Other practice location 1
2934 N Fresno St
Fresno, CA 93703-1123
Phone (559) 549-6697
Other practice location 2
3433 W Shaw Ave # 107
Fresno, CA 93711-3229
Phone (559) 476-2115
Other practice location 3
4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 353-2055
Other practice location 4
2416 W Shaw Ave Ste 114
Fresno, CA 93711-3303
Phone (559) 374-3990
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Star Behavioral Health, 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.
-
- Community/Behavioral Health Agency
- Fresno, CA
- NPI 1255218905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593302400000",
"number": "1497372247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3433 W SHAW AVE STE 102",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113229",
"telephone_number": "559-360-9195",
"fax_number": "559-570-0118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 S BARTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937022985",
"telephone_number": "559-860-4422"
}
],
"practiceLocations": [
{
"address_1": "2934 N Fresno St",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937031123",
"country_code": "US",
"telephone_number": "559-549-6697",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3433 W Shaw Ave # 107",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937113229",
"country_code": "US",
"telephone_number": "559-476-2115",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4411 E Kings Canyon Rd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937023604",
"country_code": "US",
"telephone_number": "559-353-2055",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2416 W Shaw Ave Ste 114",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937113303",
"country_code": "US",
"telephone_number": "559-374-3990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEDESMA GOMEZ",
"first_name": "EZERELI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-28",
"last_updated": "2020-06-28",
"certification_date": "2020-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"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 Jun 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.