Individual provider Active NPI

Jesse Mendez III

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1851596522
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
3152 N Millbrook Ave Ste D
Fresno, CA 93703
Phone
(559) 341-0364
Fax
(559) 341-0342
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

3152 N Millbrook Ave Ste D
Fresno, CA 93703

Mailing address

3152 N Millbrook Ave Ste D
Fresno, CA 93703-1459
Phone (559) 241-0364

Other practice location 1

2501 W Shaw Ave Ste 101
Fresno, CA 93711-3307
Phone (559) 221-1680

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

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1851596522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 N MILLBROOK AVE STE D",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031459",
            "telephone_number": "559-241-0364",
            "fax_number": "559-221-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 N MILLBROOK AVE STE D",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93703",
            "telephone_number": "559-341-0364",
            "fax_number": "559-341-0342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W Shaw Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113307",
            "country_code": "US",
            "telephone_number": "559-221-1680",
            "fax_number": "559-221-4336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JESSE",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "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 Jan 7, 2019; 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.