NPIMap

Individual provider Active NPI

Kathleen Gao Phoua Vang, M.S., LMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1639772429
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138881 Issued in CA
Practice address
718 E Minarets Ave
Fresno, CA 93720-3010
Phone
(559) 447-1114
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 122406 CA
Marriage & Family Therapist 106H00000X 138881 CA Primary

Addresses

Primary practice location

718 E Minarets Ave
Fresno, CA 93720-3010

Mailing address

7120 N Marks Ave
Fresno, CA 93711-0268
Phone (559) 439-5437

Other practice location 1

10120 Lanes Bridge Dr
Madera, CA 93636-8890
Phone (559) 431-5532

Other practice location 2

1415 W Barstow Ave
Fresno, CA 93711-3018
Phone (559) 438-9344

Other practice location 3

1027 N Van Ness Ave
Fresno, CA 93728-3429
Phone (559) 268-7613

Other practice location 4

4291 N Millbrook Ave
Fresno, CA 93726-3438
Phone (559) 224-7967

Other practice location 5

1853 E Niles Ave
Fresno, CA 93720-2342
Phone (559) 325-3892

Other practice location 6

1942 E Niles Ave
Fresno, CA 93720-2344
Phone (559) 323-4957

Other practice location 7

775 E Spruce Ave
Fresno, CA 93720-3016
Phone (559) 431-4957

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
122406CAMDClinical Social Worker
138881CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Genesis Family Center Past Accepting new patients
Promesa Behavioral Health PastSince Nov 22, 2020 Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients

Organizations & group practices 9

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1639772429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 N MARKS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110268",
            "telephone_number": "559-439-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 E MINARETS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203010",
            "telephone_number": "559-447-1114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10120 Lanes Bridge Dr",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368890",
            "country_code": "US",
            "telephone_number": "559-431-5532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 W Barstow Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113018",
            "country_code": "US",
            "telephone_number": "559-438-9344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1027 N Van Ness Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937283429",
            "country_code": "US",
            "telephone_number": "559-268-7613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4291 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937263438",
            "country_code": "US",
            "telephone_number": "559-224-7967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1853 E Niles Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202342",
            "country_code": "US",
            "telephone_number": "559-325-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1942 E Niles Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202344",
            "country_code": "US",
            "telephone_number": "559-323-4957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "775 E Spruce Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203016",
            "country_code": "US",
            "telephone_number": "559-431-4957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANG",
        "first_name": "KATHLEEN",
        "middle_name": "GAO PHOUA",
        "credential": "M.S., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122406",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138881",
            "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 Mar 30, 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.

Verify at the official NPI Registry.