Individual provider Active NPI

Pavoua Xiong, REGISTER COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1548617541
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1287830118 Issued in CA
Practice address
1310 M St
Fresno, CA 93721-1808
Phone
(559) 264-2700
Fax
(559) 264-2767
NPI assigned
May 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1287830118 CA Primary

Addresses

Primary practice location

1310 M St
Fresno, CA 93721-1808

Mailing address

1310 M St
Fresno, CA 93721-1808
Phone (559) 264-2700

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

LicenseStateTypeSpecialty
R1287830118CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1548617541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 M ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211808",
            "telephone_number": "559-264-2700",
            "fax_number": "559-264-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 M ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211808",
            "telephone_number": "559-264-2700",
            "fax_number": "559-264-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "PAVOUA",
        "name_prefix": "Ms.",
        "credential": "REGISTER COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1287830118",
            "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 Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.