Individual provider Active NPI

Dino Perez, RAS 1

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1609151463
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2910 E Olive Ave
Fresno, CA 93701-1223
Phone
(559) 981-5534
Fax
(559) 981-5539
NPI assigned
Oct 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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 CA Primary

Addresses

Primary practice location

2910 E Olive Ave
Fresno, CA 93701-1223

Mailing address

7475 N Palm Ave Ste 107
Fresno, CA 93711-5763
Phone (559) 981-5534

Other identifiers 1

IdentifierTypeStateIssuer
1044MedicaidCA

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

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1609151463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 N PALM AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115763",
            "telephone_number": "559-981-5534",
            "fax_number": "559-981-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 E OLIVE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011223",
            "telephone_number": "559-981-5534",
            "fax_number": "559-981-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "DINO",
        "credential": "RAS 1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1044",
            "state": "CA"
        }
    ],
    "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 Oct 12, 2011; 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.