Active NPI
Sierra Rose Ludel
- Clinical Social Worker
- Stockton, CA
National Provider Identifier
1770145112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1212 N California St
Stockton, CA 95202-1552 - Phone
- (209) 468-8686
- NPI assigned
- Jul 6, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Behavior Technician | 106S00000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1212 N California St
Stockton, CA 95202-1552
Mailing address
PO Box 991
Ripon, CA 95366-0991
Other practice location 1
955 W Center St Unit 12A14
Manteca, CA 95337-7300
Phone (209) 239-9600
Other practice location 2
800 Howe Ave Ste 140
Sacramento, CA 95825
Phone (916) 350-1737
Other practice location 3
955 W Center St Unit 12A14
Manteca, CA 95337-7300
Phone (209) 239-9600
Other names 1
- Sierra Mattila
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": "1562371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1770145112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 991",
"city": "RIPON",
"state": "CA",
"postal_code": "953660991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021552",
"telephone_number": "209-468-8686"
}
],
"practiceLocations": [
{
"address_1": "955 W Center St Unit 12A14",
"address_purpose": "LOCATION",
"city": "Manteca",
"state": "CA",
"postal_code": "953377300",
"country_code": "US",
"telephone_number": "209-239-9600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "800 Howe Ave Ste 140",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "95825",
"country_code": "US",
"telephone_number": "916-350-1737",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "955 W Center St Unit 12A14",
"address_purpose": "LOCATION",
"city": "Manteca",
"state": "CA",
"postal_code": "953377300",
"country_code": "US",
"telephone_number": "209-239-9600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUDEL",
"first_name": "SIERRA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-06",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SIERRA",
"last_name": "MATTILA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.