Basic Information
| Provider Information | |||||||||
| NPI: | 1427116813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRASSO | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 S CEDAR AVE | ||||||||
| Address2: | BLDG. 320 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937022908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594538300 | ||||||||
| FaxNumber: | 5594538916 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 S CEDAR AVE | ||||||||
| Address2: | BLDG. 320 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937022908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594538300 | ||||||||
| FaxNumber: | 5594538916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS7076 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.