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NPI Code Detail

MEDICARE: POVERELLO HOUSE

MEDICARE: POVERELLO HOUSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2251X00000XSupports Brokerage Agency
3101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1144809161
Entity Type Code : Organization
Provider Name (Legal Business Name) : POVERELLO HOUSE
Provider Business Mailing Address
First Line : 412 F ST
Second Line :
City : FRESNO
State : CA
Zip : 93706-3409
Country : US
Telephone Number : 559-498-6988
Fax Number :
Provider Business Practice Location Address
First Line : 412 F ST
Second Line :
City : FRESNO
State : CA
Zip : 93706-3409
Country : US
Telephone Number : 559-498-6988
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF MENTAL HEALTH SERVICES
Name : MR. XAINYAVONG VANG
Credential : LPCC 16877
Telephone Number : 559-498-6988
Provider Enumeration Date : 04/06/2021
Last Update Date : 04/10/2026

Similar Medicare Providers

1215069950 — DR. JOHN WILLIAM LOTT PSY.D., MFT
Practice Location Address:
412 F ST
FRESNO, CA
93706-3409
Practice Phone: 559-498-6988
Practice Fax:
1235454612 — MR. SOKDY SIPHONGSAY
Practice Location Address:
412 F ST
FRESNO, CA
93706-3409
Practice Phone: 559-498-6988
Practice Fax:
1518248905 — KATHLEEN ILAINE MURPHY LMFT
Practice Location Address:
412 F ST
FRESNO, CA
93706-3409
Practice Phone: 559-786-7802
Practice Fax:
1932656022 — ADRIAN JONES
Practice Location Address:
412 F ST
FRESNO, CA
93706-3409
Practice Phone: 559-498-6988
Practice Fax: 559-485-6548
1144840869 — NATHANIEL ALON SCHENCK
Practice Location Address:
412 F ST
FRESNO, CA
93706-3409
Practice Phone: 559-498-6988
Practice Fax:
1699397596 — XAINYAVONG VANG
Practice Location Address:
412 F ST
FRESNO, CA
93706-3409
Practice Phone: 559-498-6689
Practice Fax:

Directions to “POVERELLO HOUSE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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