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Individual provider Active NPI

Fortuna Israel, MD

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1780771402
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0019877 Issued in MD
Practice address
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone
(559) 600-9059
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0019877 MD Primary

Addresses

Primary practice location

4441 E Kings Canyon Rd
Fresno, CA 93702-3604

Mailing address

3535 Harding St
Carlsbad, CA 92008-5004
Phone (951) 941-9299

Other practice location 1

3535 Harding St
Suite B
Carlsbad, CA 92008
Phone (951) 941-9299

Other names 1

  • Fortuna Antwerpen Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081022000618 CA Practitioner - Psychiatry 0648338400 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Santa Barbara County AuditorGroup PAC ID 9335052083, 98 clinicians

Practice addresses (Care Compare)

4444 Calle Real
Santa Barbara, CA 93110-1002
Phone (805) 681-5190

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0019877MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara County County Auditor Current Accepting new patients
Department of State Hospitals CurrentSince Dec 10, 2020 Accepting new patients
Department of State Hospitals CurrentSince Dec 10, 2020 Accepting new patients
Santa Barbara County Auditor CurrentSince Apr 28, 2025 Accepting new patients
Santa Barbara County Department of Behavioral Wellness CurrentSince Apr 28, 2025 Accepting new patients
County of Fresno CurrentSince Oct 27, 2019 Accepting new patients
County of Fresno CurrentSince Oct 27, 2019 Accepting new patients
Telecare Corporation Past Accepting new patients
County of Santa Cruz Past Accepting new patients
Puentes Al Sur Past Accepting new patients
County of Santa Cruz Past Accepting new patients

Locations

4441 E Kings Canyon Rd
Fresno, CA 93702
Phone (559) 453-4099

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

429 N San Antonio Rd
Santa Barbara, CA 93110
Phone (805) 884-1600

4444 Calle Real
Santa Barbara, CA 93110
Phone (805) 681-5190

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1780771402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 HARDING ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920085004",
            "telephone_number": "951-941-9299",
            "fax_number": "760-637-5904"
        },
        {
            "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": "559-600-9059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Harding St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "92008",
            "country_code": "US",
            "telephone_number": "951-941-9299",
            "fax_number": "760-637-5904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "FORTUNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0019877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FORTUNA",
            "last_name": "ANTWERPEN",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.