Individual provider Active NPI

Gerardo Puga, M.A., LMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1659593192
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC51224 Issued in CA
Practice address
496 S. Barton Ave
Fresno, CA 93702
Phone
(559) 860-4422
Fax
(559) 550-0373
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 51224 CA
Marriage & Family Therapist 106H00000X MFC51224 CA Primary

Addresses

Primary practice location

496 S. Barton Ave
Fresno, CA 93702

Mailing address

3433 W. Shaw Ave #102
Fresno, CA 93711
Phone (559) 558-4051

Other practice location 1

4411 E Kings Canyon Rd # 319
Fresno, CA 93702-3604
Phone (559) 600-2382

Other identifiers 1

IdentifierTypeStateIssuer
51224OtherCACALIFORNIA BOARD OF BEHAVIORAL SCIENCES

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
51224CAMDMarriage & Family Therapist
MFC51224CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1659593192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W. SHAW AVE #102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 S. BARTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93702",
            "telephone_number": "559-860-4422",
            "fax_number": "559-550-0373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 E Kings Canyon Rd # 319",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-600-2382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGA",
        "first_name": "GERARDO",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "51224",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC51224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "51224",
            "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 Mar 21, 2022; 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.