Stacey Ann Cavanaugh Cervantes

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

98638 Issued in CA

Practice address

7080 N Marks Ave Ste 104
Fresno, CA 93711-0288

Phone

(559) 248-8550

NPI assigned

Aug 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Vitalize Behavioral Health and Psychometrics Inc.

  • Adult Mental Health Clinic/Center
  • Fresno, CA
  • NPI 1386246197
  NPD
• North Star Counseling a Licensed Clinical Social Worker Corporation

  dba North Star Counseling

  • Clinical Social Worker
  • Clovis, CA
  • NPI 1730105479
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1922290733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7080 N. MARKS STREET",
            "address_2": "SUITE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 N MARKS AVE STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110288",
            "telephone_number": "559-248-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "STACEY",
        "middle_name": "ANN CAVANAUGH",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Cervantes
• Lillia Cervantes
• Melanie Cervantes
• Michelle Cervantes
• Sandra Cervantes
• Stephanie Cervantes
• Syndell Cervantes
• Kyle Dominic de Vera Cesa
• Isaac Cesaire
• Cesar a. Vazquez M.D. Inc.

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.