Pablo Jose Canosa, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

53695 Issued in CA

Practice address

2934 N Fresno St
Fresno, CA 93703-1123

Phone

(559) 549-6697

NPI assigned

Jun 20, 2008

Last updated

Feb 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Pablo Jose Canosa Professional name

Electronic endpoints 1

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

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Central Star Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1255218905
  NPD (past)
• Hope Horizon Mental Health

  • Community/Behavioral Health Agency
  • Tulare, CA
  • NPI 1881719839
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1518128693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2934 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031123",
            "telephone_number": "559-549-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031123",
            "telephone_number": "559-549-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANOSA",
        "first_name": "PABLO",
        "middle_name": "JOSE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2022-02-11",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4785 N. First St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "93726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PABLO",
            "last_name": "CANOSA",
            "middle_name": "JOSE",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Monica Cano
• Paola Cano
• Raven Jude Cano
• Rene Cano
• Robert I. Cano, M.D.
• Rafael De Jesus Cansino-Pineda
• Caitlin Ann Cantando, FNP
• Canterbury Womens Health Care Medical Group Inc
• Trevor Cantin
• Emma Cantor

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.