Active NPI
Maricela Velasquez
- Case Manager/Care Coordinator
- Fresno, CA
National Provider Identifier
1700419306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3636 N Fist Street Ste 123
Fresno, CA 93726 - Phone
- (559) 512-6802
- NPI assigned
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9107 | CA | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3636 N Fist Street Ste 123
Fresno, CA 93726
Mailing address
2772 S Martin Luther King Blvd
Fresno, CA 93706
Phone (559) 265-4800
Other practice location 1
2772 S Martin Luther King Blvd
Fresno, CA 93706
Phone (559) 265-4800
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 |
|---|---|---|---|
| 9107 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1700419306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2772 S MARTIN LUTHER KING BLVD",
"city": "FRESNO",
"state": "CA",
"postal_code": "93706",
"telephone_number": "559-265-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3636 N FIST STREET STE 123",
"city": "FRESNO",
"state": "CA",
"postal_code": "93726",
"telephone_number": "559-512-6802"
}
],
"practiceLocations": [
{
"address_1": "2772 S Martin Luther King Blvd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "93706",
"country_code": "US",
"telephone_number": "559-265-4800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VELASQUEZ",
"first_name": "MARICELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2024-07-10",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "9107",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"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 Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.