Active NPI
James W. Backlund, LCSW
- Clinical Social Worker
- Fresno, CA
National Provider Identifier
1295847515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS11805
- Practice address
- 1060 W Sierra Ave Ste 105
Fresno, CA 93711-2063 - Phone
- (559) 437-1111
- Fax
- (559) 437-1118
- NPI assigned
- Aug 31, 2006
- 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 | LCS11805 | CA | Primary |
Addresses
Primary practice location
1060 W Sierra Ave Ste 105
Fresno, CA 93711-2063
Mailing address
1060 W Sierra Ave Ste 105
Fresno, CA 93711-2063
Phone (559) 437-1111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS11805 | CA | MD | Clinical Social Worker |
| 11805 | CA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Fresno | Current | Accepting new patients | |
| County of Fresno | Clinical | Current | Accepting new patients |
Locations
4441 E Kings Canyon Rd
Fresno, CA 93702
Phone (559) 453-4099
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fresno, CA
- NPI 1770538001
Clinical
-
- State or Local Public Health Clinic/Center
- Fresno, CA
- NPI 1174606420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295847515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 W SIERRA AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937112063",
"telephone_number": "559-437-1111",
"fax_number": "559-437-1118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 W SIERRA AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937112063",
"telephone_number": "559-437-1111",
"fax_number": "559-437-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKLUND",
"first_name": "JAMES",
"middle_name": "W.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS11805",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.