Isidro Chavez Jr.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1045 S State St
Ukiah, CA 95482-5820

Phone

(707) 467-2010

NPI assigned

Jul 29, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hilltop Recovery Services

  • Substance Abuse Rehabilitation Facility
  • Clearlake Oaks, CA
  • NPI 1578866323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1184397796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954822077",
            "telephone_number": "707-467-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 S STATE ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825820",
            "telephone_number": "707-467-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Gibson St",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954823941",
            "country_code": "US",
            "telephone_number": "707-467-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "ISIDRO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Cervantes, R.D
• Diana Chambers
• Theron HC Chan, M.D.
• Marcella Joan Chandler
• Michael Charnes
• Roger Andrew Cheitlin, MD
• Graham T Chelius, M.D.
• Shelly Marie Cheneweth, DDS
• Lorraine Chiang
• John James Chladek

• Community Health Worker in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.