Active NPI
Mallory Anne Hakes, LCSW
- Clinical Social Worker
- Vacaville, CA
National Provider Identifier
1689267015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 131265
- Practice address
- 2100 Peabody Rd
Vacaville, CA 95687-6639 - Phone
- (707) 448-6841
- NPI assigned
- Feb 17, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 131265 | CA | Primary |
Addresses
Primary practice location
2100 Peabody Rd
Vacaville, CA 95687-6639
Mailing address
28447 Hidden Lake Dr
Bonita Springs, FL 34134-1362
Phone (630) 254-7539
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131265 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758240000000",
"number": "1689267015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28447 HIDDEN LAKE DR",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341341362",
"telephone_number": "630-254-7539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 PEABODY RD",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956876639",
"telephone_number": "707-448-6841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKES",
"first_name": "MALLORY",
"middle_name": "ANNE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-17",
"last_updated": "2025-09-19",
"certification_date": "2025-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "131265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.