Active NPI
Lucille A Capo Rome, NP
- Adult Psychiatric/Mental Health Registered Nurse
- Santa Rosa, CA
National Provider Identifier
1033262654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 497364
- Practice address
- 2225 Challenger Way
Santa Rosa, CA 95407-5441 - Phone
- (707) 565-6625
- NPI assigned
- Jan 18, 2007
- Last updated
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 6863 | CA | |
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 497364 | CA | Primary |
Addresses
Primary practice location
2225 Challenger Way
Santa Rosa, CA 95407-5441
Mailing address
2225 Challenger Way
Santa Rosa, CA 95407-5441
Phone (707) 565-6625
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 497364 | CA | MD | Adult Psychiatric/Mental Health Registered Nurse |
| 6863 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Stop LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1033262654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2225 CHALLENGER WAY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954075441",
"telephone_number": "707-565-6625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 CHALLENGER WAY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954075441",
"telephone_number": "707-565-6625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPO ROME",
"first_name": "LUCILLE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "6863",
"primary": false
},
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "CA",
"license": "497364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.