Individual provider Active NPI

Jaime Brandon Ponce

  • Counselor
  • Fresno, CA
National Provider Identifier
1992622583
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
SUDRC22711 Issued in CA
Practice address
4576 E Shields Ave
Fresno, CA 93726-7220
Phone
(559) 240-9206
NPI assigned
Jul 2, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SUDRC22711 CA Primary

Addresses

Primary practice location

4576 E Shields Ave
Fresno, CA 93726-7220

Mailing address

989 2ND St
Sanger, CA 93657-2158
Phone (559) 581-8493

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": "1782950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1992622583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 2ND ST",
            "city": "SANGER",
            "state": "CA",
            "postal_code": "936572158",
            "telephone_number": "559-581-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4576 E SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937267220",
            "telephone_number": "559-240-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "JAIME",
        "middle_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-02",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "SUDRC22711",
            "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 Jul 23, 2026; 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.