Central California Asthma Collaborative

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

CENTRAL CALIFORNIA ASTHMA COLLABORATIVE

Practice address

1939 N Gateway Blvd
Suite 103
Fresno, CA 93727

Phone

(559) 272-4874

Fax

(559) 492-3802

NPI assigned

Jun 27, 2014

Organization subpart

No

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

Authorized official

Name

Tim Tyner

Title

Executive Director

Phone

(559) 272-4874

Specialties & licenses 4

Addresses

Other names 1

• CCAC Other name

Locations

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1588079545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 N GATEWAY BLVD",
            "address_2": "SUITE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93727",
            "telephone_number": "559-272-4874",
            "fax_number": "559-492-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 N GATEWAY BLVD",
            "address_2": "SUITE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93727",
            "telephone_number": "559-272-4874",
            "fax_number": "559-492-3802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 3rd St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958181100",
            "country_code": "US",
            "telephone_number": "559-272-4874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1620 N Carpenter Rd Ste D43",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953511160",
            "country_code": "US",
            "telephone_number": "559-272-4874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 W Center Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932916201",
            "country_code": "US",
            "telephone_number": "559-272-4874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Chester Ave Ste J",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933015449",
            "country_code": "US",
            "telephone_number": "559-272-4874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "375 Dover Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Delano",
            "state": "CA",
            "postal_code": "932153439",
            "country_code": "US",
            "telephone_number": "559-272-4874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA ASTHMA COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "TYNER",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "559-272-4874"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCAC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CCAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.