Active NPI
Hannah Mac Dula
- Social Worker
- American Canyon, CA
National Provider Identifier
1083069249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 328 Ring Neck St
American Canyon, CA 94503-1387 - Phone
- (707) 853-7917
- NPI assigned
- Apr 25, 2016
- Reactivated
- Jun 25, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
328 Ring Neck St
American Canyon, CA 94503-1387
Mailing address
328 Ring Neck St
American Canyon, CA 94503-1387
Phone (707) 853-7917
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390200000 | Other | CA | NAPA COUNTY MENTAL HEALTH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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": "1461542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1083069249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 RING NECK ST",
"city": "AMERICAN CANYON",
"state": "CA",
"postal_code": "945031387",
"telephone_number": "707-853-7917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 RING NECK ST",
"city": "AMERICAN CANYON",
"state": "CA",
"postal_code": "945031387",
"telephone_number": "707-853-7917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAC DULA",
"first_name": "HANNAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-25",
"last_updated": "2022-01-03",
"certification_date": "2020-06-25",
"deactivation_date": "2018-11-20",
"reactivation_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NAPA COUNTY MENTAL HEALTH",
"identifier": "390200000",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "3554 Round Barn Blvd",
"city": "Santa Rosa",
"state": "CA",
"country_code": "US",
"postal_code": "954030929",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in American Canyon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.