Individual provider Active NPI

Jennie Marie Mahalick

  • Case Manager/Care Coordinator
  • Commerce, CA
National Provider Identifier
1386971752
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
6055 E Washington Blvd
Suite 900
Commerce, CA 90040-2449
Phone
(323) 246-0960
Fax
(323) 346-0966
NPI assigned
Nov 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

6055 E Washington Blvd
Suite 900
Commerce, CA 90040-2449

Mailing address

6055 E Washington Blvd
Suite 900
Commerce, CA 90040-2449
Phone (323) 246-0960

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": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1386971752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 E WASHINGTON BLVD",
            "address_2": "SUITE 900",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900402449",
            "telephone_number": "323-246-0960",
            "fax_number": "323-346-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 E WASHINGTON BLVD",
            "address_2": "SUITE 900",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900402449",
            "telephone_number": "323-246-0960",
            "fax_number": "323-346-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHALICK",
        "first_name": "JENNIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.