Individual provider Active NPI

Nicholas Peter Dach, L.C.S.W

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1932135589
Registry record updated Jan 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 18633 Issued in CA
Practice address
2350 W Shaw Ave
Suite 118
Fresno, CA 93711-3401
Phone
(559) 696-0455
Fax
(559) 222-1339
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2009

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 LCS 18633 CA Primary

Addresses

Primary practice location

2350 W Shaw Ave
Suite 118
Fresno, CA 93711-3401

Mailing address

PO Box 5951
Fresno, CA 93755-5951
Phone (559) 696-0455

Other identifiers 2

IdentifierTypeStateIssuer
000001079OtherCAFRESNO COUNTY MEDICAL
LCS 18633OtherCAL.C.S.W. LICENSE NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060816000609 CA Practitioner - Clinical Social Worker 2365445152 Practice locations: Fresno, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5588 N Palm Ave
Suite 2
Fresno, CA 93704-1913
Phone (559) 696-0455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 18633CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233360000000",
    "number": "1932135589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5951",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937555951",
            "telephone_number": "559-696-0455",
            "fax_number": "559-222-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 W SHAW AVE",
            "address_2": "SUITE 118",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113401",
            "telephone_number": "559-696-0455",
            "fax_number": "559-222-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACH",
        "first_name": "NICHOLAS",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2009-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 18633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FRESNO COUNTY MEDICAL",
            "identifier": "000001079",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L.C.S.W. LICENSE NUMBER",
            "identifier": "LCS 18633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.