Individual provider Active NPI

Angelica Clemencia Ceja

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1962959049
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
113465 Issued in CA
Practice address
7555 N del Mar Ave Ste 206
Fresno, CA 93711-6880
Phone
(559) 554-8287
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 113465 CA Primary

Addresses

Primary practice location

7555 N del Mar Ave Ste 206
Fresno, CA 93711-6880

Mailing address

7555 N del Mar Ave Ste 206
Fresno, CA 93711-6880
Phone (559) 554-8287

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241028002814 CA Practitioner - Marriage and Family Therapist 4183065998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113465CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cultural Family Therapy Incorporated Marriage & Family Therapist CurrentSince Mar 19, 2024 Accepting new patients

Locations

351 E Barstow Ave
Ste 102
Fresno, CA 93710
Phone (559) 500-6744

7555 N Del Mar Ave
Ste 206
Fresno, CA 93711
Phone (559) 500-6744

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1962959049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 N DEL MAR AVE STE 206",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116880",
            "telephone_number": "559-554-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 N DEL MAR AVE STE 206",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116880",
            "telephone_number": "559-554-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEJA",
        "first_name": "ANGELICA",
        "middle_name": "CLEMENCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.