Mrs Theppharack Ad Sounthala, MSW | |
251 E Hackett Rd, Modesto, CA 95358-9415 | |
(209) 558-2699 | |
(209) 558-1075 |
Full Name | Mrs Theppharack Ad Sounthala |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 251 E Hackett Rd, Modesto, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083745780 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW26225 (California) | Primary |
101YP2500X | Counselor - Professional | LCS 26225 (California) | Secondary |
Entity Name | Golden Valley Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356445753 PECOS PAC ID: 4183527187 Enrollment ID: O20040128000641 |
Mailing Address | Practice Location Address |
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Mrs Theppharack Ad Sounthala, MSW 251 E Hackett Rd, Modesto, CA 95358-9415 Ph: (209) 558-2699 | Mrs Theppharack Ad Sounthala, MSW 251 E Hackett Rd, Modesto, CA 95358-9415 Ph: (209) 558-2699 |
Mr. William Leon Boddie Ii, L.C.S.W Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1524 Mchenry Ave, Suite # 450, Modesto, CA 95350 Phone: 209-557-6217 Fax: 209-557-9032 | |
Diana Faith Kigenyi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1225 Oakdale Road, Modesto, CA 95355 Phone: 209-557-6200 | |
Ms. Shamerin Bourang, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1225 Oakdale Rd, Modesto, CA 95355 Phone: 209-557-6213 | |
Mrs. Maria Edith Martinez, MSW,ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2000 W Briggsmore Ave Ste I, Modesto, CA 95350 Phone: 209-526-1476 | |
Paul Samuel Crenshaw, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 726 14th St Ste A, Modesto, CA 95354 Phone: 209-614-1440 | |
Erika Navarro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1866 Maria Ct, Modesto, CA 95354 Phone: 209-531-4268 | |
Miss Deally S. Curran, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 800 Scenic Dr, Modesto, CA 95350 Phone: 209-380-6204 Fax: 209-558-4321 |