Active NPI
Clinton Taxdahl
- Social Worker
- Sacramento, CA
National Provider Identifier
1114200136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 719 J St
Sacramento, CA 95814-2501 - Phone
- (916) 444-3118
- NPI assigned
- Sep 26, 2011
- Sex
- Male
- 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
719 J St
Sacramento, CA 95814-2501
Mailing address
2277 Fair Oaks Blvd
Ste. 440
Sacramento, CA 95825-5533
Phone (916) 441-0123
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": "1316995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1114200136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2277 FAIR OAKS BLVD",
"address_2": "STE. 440",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958255533",
"telephone_number": "916-441-0123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 J ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958142501",
"telephone_number": "916-444-3118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAXDAHL",
"first_name": "CLINTON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-26",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.