Provider Demographics
NPI:1265678981
Name:THAO, GER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GER
Middle Name:
Last Name:THAO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 N GATEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1604
Mailing Address - Country:US
Mailing Address - Phone:559-266-5200
Mailing Address - Fax:559-266-5201
Practice Address - Street 1:1960 N GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1604
Practice Address - Country:US
Practice Address - Phone:559-266-5200
Practice Address - Fax:559-266-5201
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW256531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical