Dorene Fanning, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS29760 Issued in CA

Practice address

2051 John Jones Rd
Davis, CA 95616-9701

Phone

(530) 753-3498

NPI assigned

Aug 27, 2013

Sex

Female

Sole proprietor

No

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 CA

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians

Rose-Marie Y. NietoGroup PAC ID 2163556531, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dorenefanning@tdh.allscriptsdirect.net

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.

• Cameron Park Counseling Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cameron Park, CA
  • NPI 1477760874

  Clinical

  Medicare reassignment Care Compare group NPD
• Blue Moon Senior Counseling of California LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1447678990

  CA

  Medicare reassignment Care Compare group NPD
• Hisham Soliman MD Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Folsom, CA
  • NPI 1700199080

  Clinical

  Medicare reassignment NPD
• Lumen Health and Psychological Services Inc.

  • Clinical Psychologist
  • Citrus Heights, CA
  • NPI 1366978843
  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD
• Cameron Park Counseling Center

  • Point of Service
  • Cameron Park, CA
  • NPI 1093104325
  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1831523711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1260",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956171260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 JOHN JONES RD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956169701",
            "telephone_number": "530-753-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "DORENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS29760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryjane Fabricius-Mooneyham
• Zachary Fairbrook
• Karen Falakfarsa, MFT
• Michelle Sherman Famula, M.D.
• Ruth Marya Fankushen, LMFT
• Vahid Farahyar, DDS
• Cassandra Farinsky, RN
• Samantha Farkash, DDS
• Karen Louise Farley, RD, IBCLC
• Ellen Mary Farr Peuler, LCSW

• Clinical Social Worker in Davis, CA
• Providers in Davis, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.