Active NPI
Carleta Dover
- Social Worker
- Fairfield, CA
National Provider Identifier
1568070241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 93712
- Practice address
- 1234 Empire St Ste 2200
Fairfield, CA 94533-5711 - Phone
- (707) 439-7830
- NPI assigned
- Jul 17, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | 93712 | CA | Primary |
Addresses
Primary practice location
1234 Empire St Ste 2200
Fairfield, CA 94533-5711
Mailing address
1399 Worley Rd Unit B
Suisun City, CA 94585-1970
Phone (707) 720-9692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93712 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684454400000",
"number": "1568070241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1399 WORLEY RD UNIT B",
"city": "SUISUN CITY",
"state": "CA",
"postal_code": "945851970",
"telephone_number": "707-720-9692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 EMPIRE ST STE 2200",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945335711",
"telephone_number": "707-439-7830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOVER",
"first_name": "CARLETA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-17",
"last_updated": "2023-05-19",
"certification_date": "2023-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "93712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.