Individual provider Active NPI

Eugene Masao Yamamoto, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1801398680
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65018 Issued in CA
Practice address
5151 N Palm Ave Ste 500
Fresno, CA 93704-2271
Phone
(559) 691-9715
NPI assigned
Mar 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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 65018 CA Primary

Addresses

Primary practice location

5151 N Palm Ave Ste 500
Fresno, CA 93704-2271

Mailing address

4088 Portals Ave
Clovis, CA 93619-8781
Phone (559) 691-9715

Other practice location 1

4088 Portals Ave
Clovis, CA 93619-8781
Phone (559) 691-9715

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
65018CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1801398680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4088 PORTALS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936198781",
            "telephone_number": "559-691-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N PALM AVE STE 500",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042271",
            "telephone_number": "559-691-9715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4088 Portals Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936198781",
            "country_code": "US",
            "telephone_number": "559-691-9715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "EUGENE",
        "middle_name": "MASAO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "65018",
            "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 26, 2024; 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.