NPIMap

Individual provider Active NPI

Kariisa Anne Carrasco, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1679764559
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
80824 Issued in CA
Practice address
2445 W Whites Bridge Ave
Fresno, CA 93706-1225
Phone
(559) 264-5096
Fax
(559) 223-2898
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 35204 CA
Clinical Social Worker 1041C0700X 80824 CA Primary

Addresses

Primary practice location

2445 W Whites Bridge Ave
Fresno, CA 93706-1225

Mailing address

40 E Minarets Ave
Pinedale, CA 93650-1239
Phone (559) 436-0482

Other practice location 1

1529 E Palmdale Blvd
Suite 210
Palmdale, CA 93550-2034
Phone (661) 272-9996

Other practice location 2

1529 E Palmdale Blvd
Suite 210
Palmdale, CA 93550-2034
Phone (661) 272-9996

Other practice location 3

40 E Minarets Ave
Pinedale, CA 93650-1239
Phone (559) 436-0482 ext. 4013

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

State licenses

LicenseStateTypeSpecialty
80824CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
All for Kids Organization Past Accepting new patients
Comprehensive Addiction Programs Inc PastSince Jan 22, 2023 Accepting new patients

Organizations & group practices 2

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1679764559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E MINARETS AVE",
            "city": "PINEDALE",
            "state": "CA",
            "postal_code": "936501239",
            "telephone_number": "559-436-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 W WHITES BRIDGE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937061225",
            "telephone_number": "559-264-5096",
            "fax_number": "559-223-2898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1529 E Palmdale Blvd",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935502034",
            "country_code": "US",
            "telephone_number": "661-272-9996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1529 E Palmdale Blvd",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935502034",
            "country_code": "US",
            "telephone_number": "661-272-9996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 E Minarets Ave",
            "address_purpose": "LOCATION",
            "city": "Pinedale",
            "state": "CA",
            "postal_code": "936501239",
            "country_code": "US",
            "telephone_number": "559-436-0482 x4013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "KARIISA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "35204",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80824",
            "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 Jan 17, 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.