Individual provider Active NPI

Marlene Patricia Lennon, FNP-C

  • Family Nurse Practitioner
  • Saint Helena, CA
National Provider Identifier
1023089729
Registry record updated Dec 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7432 Issued in CA
Practice address
821 Saint Helena Hwy S Ste 2
Saint Helena, CA 94574-2266
Phone
(707) 967-7551
Fax
(707) 967-7552
NPI assigned
Jan 30, 2006
Last updated
Dec 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7432 CA Primary

Addresses

Primary practice location

821 Saint Helena Hwy S Ste 2
Saint Helena, CA 94574-2266

Mailing address

821 Saint Helena Hwy S Ste 2
Saint Helena, CA 94574-2266
Phone (707) 967-7751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140416000272 CA Practitioner - Nurse Practitioner 2163654641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

110 Lynch Creek Way
Suite a
Petaluma, CA 94954-2337
Phone (707) 763-0600

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

200 W Ctr St Promenade
Anaheim, CA 92805-3960

3555 Round Barn Cir
Santa Rosa, CA 95403-1757
Phone (707) 528-1050

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7432CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Apr 1, 2014 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 1, 2014 Accepting new patients
St. Helena Hospital Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

121 Sotoyome St
Santa Rosa, CA 95405
Phone (707) 546-3141

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1023089729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SAINT HELENA HWY S STE 2",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945742266",
            "telephone_number": "707-967-7751",
            "fax_number": "707-967-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 SAINT HELENA HWY S STE 2",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945742266",
            "telephone_number": "707-967-7551",
            "fax_number": "707-967-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNON",
        "first_name": "MARLENE",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "7432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

Verify at the official NPI Registry.