Active NPI
Ivan Tunnell
- School Counselor
- Lodi, CA
National Provider Identifier
1629806070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- Practice address
- 3 S Pacific Ave
Lodi, CA 95242-3020 - Phone
- (209) 331-7695
- NPI assigned
- Jul 25, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | Primary |
Addresses
Primary practice location
3 S Pacific Ave
Lodi, CA 95242-3020
Mailing address
1305 E Vine St
Lodi, CA 95240-3148
Phone (209) 331-7000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1629806070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 E VINE ST",
"city": "LODI",
"state": "CA",
"postal_code": "952403148",
"telephone_number": "209-331-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 S PACIFIC AVE",
"city": "LODI",
"state": "CA",
"postal_code": "952423020",
"telephone_number": "209-331-7695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUNNELL",
"first_name": "IVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-25",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.