Individual provider Active NPI

Lisa Clinton

  • Case Manager/Care Coordinator
  • Vallejo, CA
National Provider Identifier
1023806460
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1709 Sonoma Blvd
Vallejo, CA 94590-6011
Phone
(415) 713-6573
NPI assigned
Apr 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1709 Sonoma Blvd
Vallejo, CA 94590-6011

Mailing address

2401 Waterman Blvd # A4-206
Fairfield, CA 94534-1800
Phone (415) 713-8725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1023806460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 WATERMAN BLVD # A4-206",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341800",
            "telephone_number": "415-713-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 SONOMA BLVD",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945906011",
            "telephone_number": "415-713-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-26",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.