Active NPI
Kellye Vargas
- Marriage & Family Therapist
- Fresno, CA
National Provider Identifier
1689073850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 107805
- Practice address
- 3715 W Fir Ave
Fresno, CA 93711-0618 - Phone
- (559) 824-5921
- NPI assigned
- Aug 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 107805 | CA | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
3715 W Fir Ave
Fresno, CA 93711-0618
Mailing address
3715 W Fir Ave
Fresno, CA 93711-0618
Phone (559) 824-5921
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
| License | State | Type | Specialty |
|---|---|---|---|
| 107805 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1689073850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 W FIR AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937110618",
"telephone_number": "559-824-5921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 W FIR AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937110618",
"telephone_number": "559-824-5921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGAS",
"first_name": "KELLYE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-13",
"last_updated": "2025-01-28",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "107805",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"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 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.