Active NPI
Sokdy Siphongsay
- Marriage & Family Therapist
- Fresno, CA
National Provider Identifier
1235454612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 126027
- Practice address
- 412 F St
Fresno, CA 93706-3409 - Phone
- (559) 498-6988
- NPI assigned
- Mar 29, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | 126027 | CA | Primary |
Addresses
Primary practice location
412 F St
Fresno, CA 93706-3409
Mailing address
412 F St
Fresno, CA 93706-3409
Phone (559) 283-7735
Other practice location 1
83 E Shaw Ave Ste 102
Fresno, CA 93710-7620
Phone (559) 226-0167
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126027 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poverello House | Marriage & Family Therapist | Current | Accepting new patients |
Locations
412 F St
Fresno, CA 93706
Phone (559) 498-6988
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1235454612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 F ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937063409",
"telephone_number": "559-283-7735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 F ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937063409",
"telephone_number": "559-498-6988"
}
],
"practiceLocations": [
{
"address_1": "83 E Shaw Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937107620",
"country_code": "US",
"telephone_number": "559-226-0167",
"fax_number": "559-226-1559",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIPHONGSAY",
"first_name": "SOKDY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-29",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "126027",
"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 May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.