Individual provider Active NPI

Sophia M Clifford, BA, CADTP

  • Student in an Organized Health Care Education/Training Program
  • Santa Rosa, CA
National Provider Identifier
1669682795
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686
Phone
(707) 568-2300
Fax
(707) 568-2304
NPI assigned
May 24, 2007
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Student in an Organized Health Care Education/Training Program 390200000X Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686

Mailing address

1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686
Phone (707) 568-2300

Other practice location 1

2403 Professional Dr
Suite 101
Santa Rosa, CA 95403-3007
Phone (707) 544-3295

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
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeworks of Sonoma County CurrentSince Sep 29, 2024 Accepting new patients
Community Action Partnership of Sonoma County CurrentSince Sep 29, 2024 Accepting new patients
Drug Abuse Alternatives Center Past Accepting new patients
Drug Abuse Alternatives Center Past Accepting new patients

Locations

1260 N Dutton Ave
Ste 220
Santa Rosa, CA 95401
Phone (707) 544-6911

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1669682795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE STE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014686",
            "telephone_number": "707-568-2300",
            "fax_number": "707-568-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE STE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014686",
            "telephone_number": "707-568-2300",
            "fax_number": "707-568-2304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2403 Professional Dr",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954033007",
            "country_code": "US",
            "telephone_number": "707-544-3295",
            "fax_number": "707-544-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "SOPHIA",
        "middle_name": "M",
        "credential": "BA, CADTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.