George Allan Fogle, LCSW, CCM

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 19284 Issued in CA

Practice address

4601 Dale Rd
Modesto, CA 95356-9718

Phone

(209) 735-5000

NPI assigned

Jul 1, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Asian Health Services

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1003134545
  NPD
• Asian Health Services

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1073827242
  NPD
• Asian Health Services

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1841331402
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1346402245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5669 GOLD CREEK DR",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945525443",
            "telephone_number": "510-502-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 DALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569718",
            "telephone_number": "209-735-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "GEORGE",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "LCSW, CCM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 19284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheron Floyd
• Larayna Louise Flud
• Joseph K Fluence, MD
• Frank Fogal, PT
• Steven P Fogel, M.D.
• Sara Folan
• Barbara M Fong, MD
• Angelique M Fonseca
• Yzelle Fonseca
• Paul Athony Forakis, D.C.

• Clinical Social Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.

Verify at the official NPI Registry.