Active NPI
Clinton Spellman
- Student in an Organized Health Care Education/Training Program
- West Sacramento, CA
National Provider Identifier
1174344154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3050 Beacon Blvd
West Sacramento, CA 95691-3467 - Phone
- (916) 594-3148
- NPI assigned
- Oct 22, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary |
Addresses
Primary practice location
3050 Beacon Blvd
West Sacramento, CA 95691-3467
Mailing address
9516 Appalachian Dr
Sacramento, CA 95827-1109
Phone (916) 612-7748
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": "1729555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1174344154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9516 APPALACHIAN DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958271109",
"telephone_number": "916-612-7748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3050 BEACON BLVD",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956913467",
"telephone_number": "916-594-3148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLMAN",
"first_name": "CLINTON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-22",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.