Individual provider · Type 1 NPI

Pukan Phaoudom

Clinical Social Worker · Fresno, CA

NPI number 1790844512 Active

Practice location

1925 E Dakota Ave
Fresno, CA 93726-4821

Call (559) 600-5982 Map

Other practice locations

  • 2171 N Fine Ave, Fresno, CA 93727-1519 · (559) 455-2040

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XNone listed
Clinical Social Worker Primary 1041C0700XLCSW25857 (CA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

133 other providers at this address

Other clinical social worker providers in Fresno

See all in Fresno →

About NPI 1790844512

Pukan Phaoudom's National Provider Identifier is 1790844512, issued on Dec 7, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fresno, CA. The record was last updated on May 20, 2026.