Healthcare Provider Details

I. General information

NPI: 1730830837
Provider Name (Legal Business Name): NIKIA JANELL BATEMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3688 E SHIELDS AVE
FRESNO CA
93726-6922
US

IV. Provider business mailing address

4460 W SHAW AVE # PMB229
FRESNO CA
93722-6210
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-6810
  • Fax:
Mailing address:
  • Phone: 559-420-6038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number105352
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number140614
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number105352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: