Michael Hurtado, PSYD PSYCHOLOGIST

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

32086 Issued in CA

Practice address

64 E Weldon Ave
Fresno, CA 93704

Phone

(559) 300-6643

NPI assigned

Nov 6, 2020

Last updated

Nov 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Matrix Behavioral Health, Inc

  • Clinical Psychologist
  • Visalia, CA
  • NPI 1316676737
  NPD

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1801497607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2113",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932322113",
            "telephone_number": "559-300-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 E WELDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93704",
            "telephone_number": "559-300-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "MICHAEL",
        "credential": "PSYD PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "CA",
            "license": "32086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Hupp, DPT
• Vincent Edward Hurley
• Glen Lee Hurst
• Chantal Nicole Hurtado Villanueva
• Angelita Sofia Hurtado
• Rosalina Marie Hurtado
• Victoria Hurtado
• Walter Samuel Hurtado, PA C
• George Husari, DO
• Shaikh Muhammad Husnain, MD

• Health Service Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Health Service Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.