Individual provider Active NPI

Latossia Delores Barda, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1639819824
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127772 Issued in CA
Practice address
1396 W Herndon Ave
Fresno, CA 93711-7126
Phone
(559) 256-0100
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 127772 CA Primary

Addresses

Primary practice location

1396 W Herndon Ave
Fresno, CA 93711-7126

Mailing address

1004 E Clinton Ave
Fresno, CA 93704-5630
Phone (550) 274-3431

Other practice location 1

1925 E Dakota Ave Ste Q
Fresno, CA 93726-4821
Phone (559) 256-0100

Other names 1

  • Latossia Delores Kraschel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250103002093 CA Practitioner - Clinical Social Worker 8527596543 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127772CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kings View CurrentSince Dec 17, 2024 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
Kings View Current Accepting new patients
Kings View CurrentSince Dec 17, 2024 Accepting new patients

Locations

1617 E Saginaw Way
Ste 101
Fresno, CA 93704
Phone (559) 241-8582

1396 W Herndon Ave
Fresno, CA 93711
Phone (559) 216-1997

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 4

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1639819824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937045630",
            "telephone_number": "550-274-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1396 W HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937117126",
            "telephone_number": "559-256-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 E Dakota Ave Ste Q",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937264821",
            "country_code": "US",
            "telephone_number": "559-256-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARDA",
        "first_name": "LATOSSIA",
        "middle_name": "DELORES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "127772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATOSSIA",
            "last_name": "KRASCHEL",
            "middle_name": "DELORES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.