Theb Manivanh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28251 Issued in CA

Practice address

505 N Court St
Visalia, CA 93291-4912

Phone

(559) 730-7566

NPI assigned

Oct 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Lake County Tribal Health Consortium IncGroup PAC ID 8729975545, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lake County Tribal Health Consortium Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeport, CA
  • NPI 1881697381
  Medicare reassignment Care Compare group NPD
• Lake County Tribal Health Southshore Clinic

  • Federally Qualified Health Center (FQHC)
  • Clearlake, CA
  • NPI 1063158038
  NPD
• Tulare County Office of Education

  • Local Education Agency (LEA)
  • Visalia, CA
  • NPI 1457612004
  NPD (past)

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1649459835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954531950",
            "telephone_number": "707-263-8382",
            "fax_number": "707-263-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N COURT ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914912",
            "telephone_number": "559-730-7566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Bevins Ct",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "954539754",
            "country_code": "US",
            "telephone_number": "707-263-8382",
            "fax_number": "707-263-0329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANIVANH",
        "first_name": "THEB",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-24",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "28251",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmanivanh@vusd.us",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "505 N Court St",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932914912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Malony
• April Macale Manalaysay, D.O.
• Christine Marie Mancillas
• Monica Manga, M.D.
• Jennifer Johnson Mangine, B.A., RAS,SUDC-C
• Jasneet Mann
• Sukhmanjeet Kaur Mann, MD
• Tejinder Kaur Mann, M.D.
• Febrianty P Manna, CRNA
• Amtonio F Manquero

• Clinical Social Worker in Visalia, CA
• Providers in Visalia, 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 Aug 4, 2025; 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.

Verify at the official NPI Registry.