Pukan Phaoudom
NPI 1790844512 · Clinical Social Worker · Fresno, CA
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pukan Phaoudom is a Clinical Social Worker provider in Fresno, CA (NPI 1790844512).
Provider details
- NPI number
- 1790844512
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 2171 N Fine AveFresno, CA 93727-1519Phone: (559) 455-2040
Registry dates
- Enumerated
- 2006-12-07
- Last updated
- 2026-05-20
- Certified
- 2026-05-20
Frequently asked questions
- What is Pukan Phaoudom's NPI number?
- Pukan Phaoudom's National Provider Identifier (NPI) is 1790844512, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Pukan Phaoudom's specialty?
- Pukan Phaoudom is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Pukan Phaoudom located?
- Pukan Phaoudom's practice location on file with NPPES is 1925 E Dakota Ave, Fresno, CA 93726-4821.
- What is Pukan Phaoudom's phone number?
- The practice phone number listed in the NPPES registry for Pukan Phaoudom is (559) 600-5982.
- Does Pukan Phaoudom accept Medicare?
- Pukan Phaoudom is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Pukan Phaoudom's NPI active?
- Yes — Pukan Phaoudom's NPI (1790844512) is active in the NPPES registry as of the last update on 2026-05-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.