Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Herthao Ly, BASW

Individual provider Case Management Agency · NPI 1912375676

Herthao Ly, BASW is a Clinical Social Worker in Sacramento, California. Qualified in 2017, 9 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

3737 Marconi Ave
Sacramento, CA 95821-5303
Phone: (916) 480-1801
Fax: (916) 854-1809
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Case Management Agency Taxonomy 251B00000X

Record details

NPI number1912375676
Entity typeIndividual (Type 1)
GenderMale
Credentials BASW
Sole proprietorYes
NPI enumeratedSeptember 10, 2015
Last updated in NPPESFebruary 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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