Ms Promila M Mahtab, RN - Counselor in Fresno, CA

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Ms Promila M Mahtab, RN is a Registered Nurse - Psychiatric/mental Health based in Fresno, California. Ms Promila M Mahtab is licensed to practice in California (license number 499674) and her current practice location is 4411 E Kings Canyon Rd, Fresno, California. She can be reached at her office (for appointments etc.) via phone at (559) 252-4800.

NPI number for Ms Promila M Mahtab is 1679703136 and her current mailing address is 2620 Richert Ave, Clovis, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1679703136.

Contact Information

Ms Promila M Mahtab, RN
4411 E Kings Canyon Rd,
Fresno, CA 93702-3604
(559) 252-4800
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMs Promila M Mahtab
GenderFemale
SpecialityRegistered Nurse - Psychiatric/mental Health
Location4411 E Kings Canyon Rd, Fresno, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1679703136
  • Provider Enumeration Date: 07/19/2009
  • Last Update Date: 05/03/2018

Medical Identifiers

Medical identifiers for Ms Promila M Mahtab such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679703136NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) (* (Not Available))Secondary
163WP0808XRegistered Nurse - Psychiatric/mental Health 499674 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Promila M Mahtab is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Promila M Mahtab, RN
2620 Richert Ave,
Clovis, CA 93611

Ph: (559) 292-0420		Ms Promila M Mahtab, RN
4411 E Kings Canyon Rd,
Fresno, CA 93702-3604

Ph: (559) 252-4800

Reviews and Comments


Registered Nurse in Fresno, CA


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