Individual provider Active NPI

Alexander Gil, RADTI: #R1352310619

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1730673963
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11904 Issued in CA
Practice address
3707 E Shields Ave
Fresno, CA 93726
Phone
(559) 229-9040
Fax
(559) 229-9060
NPI assigned
Jun 20, 2018
Last updated
May 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 11904 CA Primary

Addresses

Primary practice location

3707 E Shields Ave
Fresno, CA 93726

Mailing address

3707 E Shields Ave
Fresno, CA 93726-7029
Phone (559) 229-9040

Other practice location 1

3707 E Shields Ave
Fresno, CA 93726
Phone (559) 229-9040

Other identifiers 2

IdentifierTypeStateIssuer
R1352310619OtherCACCAPP
11904OtherCACADTP

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
11904CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1730673963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937267029",
            "telephone_number": "559-229-9040",
            "fax_number": "559-229-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93726",
            "telephone_number": "559-229-9040",
            "fax_number": "559-229-9060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3707 E Shields Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93726",
            "country_code": "US",
            "telephone_number": "559-229-9040",
            "fax_number": "559-229-9060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIL",
        "first_name": "ALEXANDER",
        "credential": "RADTI:  #R1352310619",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "11904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAPP",
            "identifier": "R1352310619",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADTP",
            "identifier": "11904",
            "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 7, 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.

Verify at the official NPI Registry.