Active NPI
Ger Thao, LCSW
- Clinical Social Worker
- Fresno, CA
National Provider Identifier
1265678981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW25653
- Practice address
- 1960 N Gateway Blvd
Fresno, CA 93727-1604 - Phone
- (559) 266-5200
- Fax
- (559) 266-5201
- NPI assigned
- Dec 30, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW25653 | CA | Primary |
Addresses
Primary practice location
1960 N Gateway Blvd
Fresno, CA 93727-1604
Mailing address
1960 N Gateway Blvd
Fresno, CA 93727-1604
Phone (559) 266-5200
Other practice location 1
4879 E Kings Canyon Rd
Fresno, CA 93727-3811
Phone (559) 255-8395 ext. 244
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25653 | CA | MD | Clinical Psychologist |
| LCSW25653 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1265678981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 N GATEWAY BLVD",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271604",
"telephone_number": "559-266-5200",
"fax_number": "559-266-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 N GATEWAY BLVD",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271604",
"telephone_number": "559-266-5200",
"fax_number": "559-266-5201"
}
],
"practiceLocations": [
{
"address_1": "4879 E Kings Canyon Rd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937273811",
"country_code": "US",
"telephone_number": "559-255-8395 x244",
"fax_number": "559-452-8062",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THAO",
"first_name": "GER",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-30",
"last_updated": "2023-01-16",
"certification_date": "2023-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW25653",
"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 Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.