Individual provider Active NPI

Jennifer Louise Lallo, MSN, NP

  • Nurse Practitioner
  • Clovis, CA
National Provider Identifier
1780026294
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23124 Issued in CA
Practice address
785 Medical Center Drive West
203
Clovis, CA 93611-1324
Phone
(559) 387-1900
Fax
(559) 387-1950
NPI assigned
Jul 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 797429 CA
Family Nurse Practitioner 363LF0000X 23124 CA
Nurse Practitioner 363L00000X 23124 CA Primary

Addresses

Primary practice location

785 Medical Center Drive West
203
Clovis, CA 93611-1324

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029000093 CA Practitioner - Nurse Practitioner 9335374305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

45 E River Park PL W
Fresno, CA 93720-1565
Phone (559) 320-0530

805 W Acequia Ave
Suite 2D
Visalia, CA 93291-6164
Phone (559) 320-0530

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Nov 1, 2020 Accepting new patients
University Faculty Associates , Inc. CurrentSince Apr 1, 2015 Accepting new patients
University Faculty Associates, Inc. CurrentSince Apr 1, 2015 Accepting new patients
University Faculty Associates, Inc. Past Accepting new patients

Locations

785 N Medical Center Dr W
Ste 203
Clovis, CA 93611
Phone (559) 387-1900

785 N Medical Center Dr W
#203
Clovis, CA 93611
Phone (559) 387-1900

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1780026294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 MEDICAL CENTER DRIVE WEST",
            "address_2": "203",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936111324",
            "telephone_number": "559-387-1900",
            "fax_number": "559-387-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLO",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "MSN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "797429",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23124",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.