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NPI Code Detail

MEDICARE: MR. GER THAO LCSW

MEDICARE: MR. GER THAO LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW25653CA

General Provider Information

NPI Number : 1265678981
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GER THAO LCSW
Provider Business Mailing Address
First Line : 1960 N GATEWAY BLVD
Second Line :
City : FRESNO
State : CA
Zip : 93727-1604
Country : US
Telephone Number : 559-266-5200
Fax Number : 559-266-5201
Provider Business Practice Location Address
First Line : 1960 N GATEWAY BLVD
Second Line :
City : FRESNO
State : CA
Zip : 93727-1604
Country : US
Telephone Number : 559-266-5200
Fax Number : 559-266-5201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2008
Last Update Date : 01/16/2023

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Directions to “ MR. GER THAO LCSW” Practice Location

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