Nanelle Lavinia Jones-Sullivan, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

G64660 Issued in CA

Practice address

1119 E Monte Vista Ave
Vacaville, CA 95688-3009

Phone

(707) 469-4540

NPI assigned

Nov 20, 2006

Last updated

Jun 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1396819561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SANTA CRUZ CT",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956883559",
            "telephone_number": "707-685-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 E MONTE VISTA AVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956883009",
            "telephone_number": "707-469-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES-SULLIVAN",
        "first_name": "NANELLE",
        "middle_name": "LAVINIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G64660",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G64660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Shanae Johnson, LVN
• Randy Lee Johnson, DMD
• Raven Johnson
• Roy W. Johnson, PHD
• Towanda Jones-Collins
• Alyssa Jones
• Jennifer Elisha Jones
• Kenneth L Jones II, DDS
• Miarah Jones
• Thomas Robert Jones, LCSW

• Child & Adolescent Psychiatry Physician in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.