Active NPI
Helene Sullivan
- Clinical Social Worker
- Citrus Heights, CA
National Provider Identifier
1336648773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 79803
- Practice address
- 5941 San Juan Ave Ste 12B
Citrus Heights, CA 95610-6539 - Phone
- (530) 574-1523
- NPI assigned
- Feb 11, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 79803 | CA | Primary |
Addresses
Primary practice location
5941 San Juan Ave Ste 12B
Citrus Heights, CA 95610-6539
Mailing address
417 Mace Blvd
Suite J 168
Davis, CA 95618
Phone (530) 574-1523
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79803 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518307200000",
"number": "1336648773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 MACE BLVD",
"address_2": "SUITE J 168",
"city": "DAVIS",
"state": "CA",
"postal_code": "95618",
"telephone_number": "530-574-1523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5941 SAN JUAN AVE STE 12B",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956106539",
"telephone_number": "530-574-1523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "HELENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-11",
"last_updated": "2018-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "79803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.