Individual provider Active NPI

Maria Carmen Maravilla

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1639478472
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
7170 N Financial Dr
Fresno, CA 93720-2939
Phone
(559) 221-8100
Fax
(559) 221-8101
NPI assigned
Mar 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 Primary

Addresses

Primary practice location

7170 N Financial Dr
Fresno, CA 93720-2939

Mailing address

13501 S Henderson Rd
Caruthers, CA 93609-9572
Phone (559) 709-0052

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": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1639478472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 S HENDERSON RD",
            "city": "CARUTHERS",
            "state": "CA",
            "postal_code": "936099572",
            "telephone_number": "559-709-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7170 N FINANCIAL DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202939",
            "telephone_number": "559-221-8100",
            "fax_number": "559-221-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVILLA",
        "first_name": "MARIA",
        "middle_name": "CARMEN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "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 Mar 18, 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.