Tanisha J Ganub
Social Worker, Clinical in Stockton, CA. Individual provider (NPI-1).
NPI number1366066441
StatusActive
Last updated in NPPESJun 3, 2020
Details
- NPI
- 1366066441
- Entity type
- Individual (NPI-1)
- Name
- Tanisha J Ganub
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2020
- Certification date
- Jun 3, 2020
- Last updated
- Jun 3, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
1803 W March Ln Ste C&DStockton, CA 95207-6414
Phone 209-636-5353
Mailing address
Po Box 581014Elk Grove, CA 95758-0017
Phone 916-825-2545
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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