Active NPI
Lisa Marie Godoy, CADC-CAS CS12540919
- Case Manager/Care Coordinator
- Hemet, CA
National Provider Identifier
1770864936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- CS12540919
- Practice address
- 1055 N State St
Hemet, CA 92543-1474 - Phone
- (951) 522-2668
- Fax
- (951) 715-5060
- NPI assigned
- Sep 1, 2011
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CS12540919 | CA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CS12540919 | CA |
Addresses
Primary practice location
1055 N State St
Hemet, CA 92543-1474
Mailing address
3525 Presley Ave
Riverside, CA 92507-4453
Phone (951) 782-2400
Other practice location 1
3525 Presley Ave
Riverside, CA 92507-4453
Phone (951) 782-2400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 333903 | Medicaid | CA | |
| 333901 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CS12540919 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716249600000",
"number": "1770864936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3525 PRESLEY AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925074453",
"telephone_number": "951-782-2400",
"fax_number": "951-715-5060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N STATE ST",
"city": "HEMET",
"state": "CA",
"postal_code": "925431474",
"telephone_number": "951-522-2668",
"fax_number": "951-715-5060"
}
],
"practiceLocations": [
{
"address_1": "3525 Presley Ave",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925074453",
"country_code": "US",
"telephone_number": "951-782-2400",
"fax_number": "951-715-5060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GODOY",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "CADC-CAS CS12540919",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-01",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "CS12540919",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CS12540919",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "333903",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "333901",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.