Alisa Jaffe Holleron

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24452 Issued in CA

Practice address

232 Lee St Apt F1
Evanston, IL 60202-1488

Phone

(530) 417-2869

Fax

(916) 933-5051

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1669697579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 GOLDEN FOOTHILL PKWY",
            "address_2": "SUITE 6",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629649",
            "telephone_number": "916-933-5011",
            "fax_number": "916-933-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 LEE ST APT F1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021488",
            "telephone_number": "530-417-2869",
            "fax_number": "916-933-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLERON",
        "first_name": "ALISA",
        "middle_name": "JAFFE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey A Hojnicki, ATC
• Taylor Morey Holderfield
• Nancy Holdsworth, CNP
• Catherine Holecek
• Julie Shields Holland, MD
• Claudine Marie Holloway, MS OTR/L
• Lilian Holm, PT
• Daryl Holmes Sr., MHS
• Tanica Monae Holmes
• Nathan Paul Holt, M.D.

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.