Active NPI
Thomas E Granata, PH.D.
- Clinical Psychologist
- Fresno, CA
National Provider Identifier
1528115169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY7996
- Practice address
- 5740 N Palm Ave
Suite 105
Fresno, CA 93704-1800 - Phone
- (559) 431-1900
- Fax
- (559) 431-1951
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | PSY7996 | CA | Primary |
Addresses
Primary practice location
5740 N Palm Ave
Suite 105
Fresno, CA 93704-1800
Mailing address
5740 N Palm Ave
Suite 105
Fresno, CA 93704-1800
Phone (559) 431-1900
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040402000132 | CA | Practitioner - Clinical Psychologist | 9032101548 | Practice locations: Fresno, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Univ of Nevada, Las Vegas School of Dental Med, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5740 N Palm Ave
Fresno, CA 93704-1800
Phone (559) 431-1900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7996 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271808000000",
"number": "1528115169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5740 N PALM AVE",
"address_2": "SUITE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937041800",
"telephone_number": "559-431-1900",
"fax_number": "559-431-1951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5740 N PALM AVE",
"address_2": "SUITE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937041800",
"telephone_number": "559-431-1900",
"fax_number": "559-431-1951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANATA",
"first_name": "THOMAS",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2010-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY7996",
"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 Apr 21, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.