Radiance Clinton

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1949 5TH St
Davis, CA 95616-4026

Phone

(530) 574-5138

NPI assigned

Jan 17, 2024

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1487415410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 CHESTNUT LN",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956161302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 5TH ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164026",
            "telephone_number": "530-574-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "RADIANCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer P. Clary, MD
• Patricia Claxton
• Kenneth C Clay, MD
• Clear Blue Nutrition Inc
• Andrea Marie Clegg, D.M.D
• Bryon D Cloyd, D.C.
• Melinda Coates
• Theodore W Coates, PA-C
• Bethany Basinger Coburn, LCSW
• Annette Cody, ANNETTE CODY

• Community Health Worker in Davis, CA
• Providers in Davis, 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 Jan 17, 2024; 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.