IndividualActive
Promila Mahtab, R.N.
NPI 1679703136 · Psychiatric/Mental Health Registered Nurse · Fresno, CA
Provider details
- NPI number
- 1679703136
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Registered NurseNursing Service Providers
- Credential
- R.N.
- Sex
- Female
- Sole proprietor
- No
- License
- 499674 (CA)
Specialties & taxonomies
Nursing Service Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
7 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3141 N. Millbrook Ave.
Fresno, CA 93703
Phone: (559) 453-1008
Street-level locationGet directions
Mailing address
2620 Richert Ave
Clovis, CA 93611
Additional practice locations (6)
- 3520 E Shields Ave Ste 102Fresno, CA 93726-6923Phone: (559) 538-1230
- 4411 E. Kings Canyon RdFresno, CA 93702Phone: (559) 453-1008
- 3133b N Millbrook AveFresno, CA 93703-1425Phone: (559) 453-1008
- 3147 N Millbrook AveFresno, CA 93703-1425Phone: (559) 453-1008
- 4411 E Cesar Chavez BlvdFresno, CA 93702-3604Phone: (559) 453-1008
- 3127 N Millbrook AveFresno, CA 93703-1425Phone: (559) 453-1008
Registry dates
- Enumerated
- 2009-07-19
- Last updated
- 2026-05-18
- Certified
- 2026-05-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.