Individual provider Active NPI

Eric Paul Padillo

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1700250305
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT138782
Practice address
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone
(559) 600-9180
NPI assigned
Nov 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF89278 CA
Marriage & Family Therapist 106H00000X AMFT89278 CA
Marriage & Family Therapist 106H00000X 138782 CA
Marriage & Family Therapist 106H00000X LMFT138782 Primary

Addresses

Primary practice location

4441 E Kings Canyon Rd
Fresno, CA 93702-3604

Mailing address

1657 Lily Ave
El Cajon, CA 92021-3539
Phone (619) 990-8695

Other practice location 1

3133 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 600-9180

Other identifiers 1

IdentifierTypeStateIssuer
136MedicaidCA

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

LicenseStateTypeSpecialty
138782CAMDMarriage & Family Therapist
AMFT89278CAMDMarriage & Family Therapist
IMF89278CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peace Officers Chaplaincy of Fresno County Marriage & Family Therapist PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1700250305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 LILY AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920213539",
            "telephone_number": "619-990-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3133 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-600-9180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADILLO",
        "first_name": "ERIC",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF89278",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT89278",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138782",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "LMFT138782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136",
            "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 May 10, 2023; 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.