Individual provider Active NPI

Donna Ammon, RADT-1

  • Counselor
  • Sacramento, CA
National Provider Identifier
1629520044
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
650 Howe Ave # 400B
Sacramento, CA 95825-4731
Phone
(916) 993-4131
Fax
(916) 993-4886
NPI assigned
Nov 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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 R1233011016 CA
Counselor 101Y00000X CA Primary

Addresses

Primary practice location

650 Howe Ave # 400B
Sacramento, CA 95825-4731

Mailing address

310 Harris Ave
Sacramento, CA 95838-3249
Phone (916) 649-6793

Other practice location 1

310 Harris Ave
Sacramento, CA 95838-3249
Phone (916) 649-6793 ext. 3302

Other identifiers 1

IdentifierTypeStateIssuer
1629520044MedicaidCA

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
R1233011016CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
TLCS, Inc. PastSince Jun 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1629520044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HARRIS AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383249",
            "telephone_number": "916-649-6793",
            "fax_number": "916-929-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HOWE AVE # 400B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254731",
            "telephone_number": "916-993-4131",
            "fax_number": "916-993-4886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Harris Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958383249",
            "country_code": "US",
            "telephone_number": "916-649-6793 x3302",
            "fax_number": "916-929-7411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMMON",
        "first_name": "DONNA",
        "credential": "RADT-1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1233011016",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629520044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.