Active NPI
Panhia Moua
- Addiction (Substance Use Disorder) Counselor
- Fresno, CA
National Provider Identifier
1922882018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 19601
- Practice address
- 1204 W Shaw Ave # 102
Fresno, CA 93711-3706 - Phone
- (559) 681-1947
- NPI assigned
- Aug 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 19601 | CA | Primary |
| Community Health Worker | 172V00000X |
Addresses
Primary practice location
1204 W Shaw Ave # 102
Fresno, CA 93711-3706
Mailing address
4879 E Kings Canyon Rd
Fresno, CA 93727-3811
Phone (559) 255-8395
Other practice location 1
4855 E Kings Canyon Rd
Fresno, CA 93727-3811
Phone (559) 255-8395
Other practice location 2
4871 E Kings Canyon Rd
Fresno, CA 93727-3811
Phone (559) 255-8395
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19601 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central California Recovery | Past | Accepting new patients | |
| The Fresno Center | Past | Accepting new patients | |
| The Fresno Center | Past | Accepting new patients | |
| The Fresno Center | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Fresno, CA
- NPI 1295972446
-
- Marriage & Family Therapist
- Fresno, CA
- NPI 1174710651
-
- Psychiatry Physician
- Fresno, CA
- NPI 1437347721
-
- Adult Day Care Clinic/Center
- Fresno, CA
- NPI 1770197659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1922882018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4879 E KINGS CANYON RD",
"city": "FRESNO",
"state": "CA",
"postal_code": "937273811",
"telephone_number": "559-255-8395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 W SHAW AVE # 102",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113706",
"telephone_number": "559-681-1947"
}
],
"practiceLocations": [
{
"address_1": "4855 E Kings Canyon Rd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937273811",
"country_code": "US",
"telephone_number": "559-255-8395",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4871 E Kings Canyon Rd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937273811",
"country_code": "US",
"telephone_number": "559-255-8395",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOUA",
"first_name": "PANHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-21",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "19601",
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
}
],
"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 Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.