Stacie Ford

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

603 Bercut Drive Suite C
Sacarmento, CA 95811

Phone

(916) 441-0226

NPI assigned

May 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Red House Behavior Resources, Inc.

  • Behavior Analyst
  • San Francisco, CA
  • NPI 1962838409
  NPD (past)

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1649835497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 BERCUT DRIVE SUITE C",
            "city": "SACARMENTO",
            "state": "CA",
            "postal_code": "958113724",
            "telephone_number": "916-517-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BERCUT DRIVE SUITE C",
            "city": "SACARMENTO",
            "state": "CA",
            "postal_code": "95811",
            "telephone_number": "916-441-0226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Waterman Blvd Ste A4-309",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945341800",
            "country_code": "US",
            "telephone_number": "888-362-3970",
            "fax_number": "508-882-7687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2593 Chalmette Ct Unit 26",
            "address_purpose": "LOCATION",
            "city": "Rocklin",
            "state": "CA",
            "postal_code": "956773724",
            "country_code": "US",
            "telephone_number": "916-517-5316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "STACIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Lyon, DDS

• Community Health Worker in Sacarmento, CA
• Providers in Sacarmento, 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 Apr 9, 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.