Individual provider Active NPI

Carolina Lissette Palacios

  • Case Manager/Care Coordinator
  • Huntington Beach, CA
National Provider Identifier
1134869563
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
8041 Newman Ave
Huntington Beach, CA 92647-7034
Phone
(888) 499-9303
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

8041 Newman Ave
Huntington Beach, CA 92647-7034

Mailing address

8041 Newman Ave
Huntington Beach, CA 92647-7034
Phone (888) 499-9303

Other identifiers 1

IdentifierTypeStateIssuer
1306015425MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.altamed.org/?gclid=CjwKCAjwxZqSBhAHEiwASr9n9ECCMTJxHYBbLOFmD55h6ZW9AkB_-jh1cZu9d0TfpuEd1SJNVQgywxoCrIsQAvD_BwE Direct

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": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1134869563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8041 NEWMAN AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477034",
            "telephone_number": "888-499-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8041 NEWMAN AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477034",
            "telephone_number": "888-499-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS",
        "first_name": "CAROLINA",
        "middle_name": "LISSETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306015425",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.altamed.org/?gclid=CjwKCAjwxZqSBhAHEiwASr9n9ECCMTJxHYBbLOFmD55h6ZW9AkB_-jh1cZu9d0TfpuEd1SJNVQgywxoCrIsQAvD_BwE",
            "affiliation": "N",
            "endpointDescription": "https://www.altamed.org/?gclid=CjwKCAjwxZqSBhAHEiwASr9n9ECCMTJxHYBbLOFmD55h6ZW9AkB_-jh1cZu9d0TfpuEd1SJNVQgywxoCrIsQAvD_BwE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8041 Newman Ave",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926477034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.

Verify at the official NPI Registry.