Individual provider Active NPI

Mario Aguero Jr., RAC

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1912782822
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
16167 Issued in CA
Practice address
539 N Van Ness Ave
Fresno, CA 93728-3419
Phone
(559) 547-9819
Fax
(559) 498-0507
NPI assigned
Aug 29, 2023
Sex
Male
Sole proprietor
Yes

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
16167CAMDPrimary Care Nurse Practitioner

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16167 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

539 N Van Ness Ave
Fresno, CA 93728-3419

Mailing address

539 N Van Ness Ave
Fresno, CA 93728-3419
Phone (559) 547-9819

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 16, 2023.

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1912782822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283419",
            "telephone_number": "559-547-9819",
            "fax_number": "559-498-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283419",
            "telephone_number": "559-547-9819",
            "fax_number": "559-498-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUERO",
        "first_name": "MARIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "16167",
            "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 Oct 16, 2023; 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.