Individual provider Active NPI

Chanel C Segovia

  • Clinical Social Worker
  • Roseville, CA
National Provider Identifier
1407495880
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone
(916) 787-8800
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1366641019 CA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

101 Cirby Hills Dr
Roseville, CA 95678-4360

Mailing address

101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone (916) 787-8800

Other practice location 1

1530 3rd St Ste 106
Lincoln, CA 95648-2500
Phone (916) 434-8927

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

LicenseStateTypeSpecialty
R1366641019CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1407495880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CIRBY HILLS DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784360",
            "telephone_number": "916-787-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIRBY HILLS DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784360",
            "telephone_number": "916-787-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 3rd St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "CA",
            "postal_code": "956482500",
            "country_code": "US",
            "telephone_number": "916-434-8927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGOVIA",
        "first_name": "CHANEL",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1366641019",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.