Active NPI
Lindsey Ryburn, M.S.W.
- Clinical Social Worker
- Fairfield, CA
National Provider Identifier
1881889186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 61306
- Practice address
- 2101 Courage Dr
Fairfield, CA 94533-6717 - Phone
- (707) 784-7990
- NPI assigned
- Sep 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 61306 | CA | Primary |
Addresses
Primary practice location
2101 Courage Dr
Fairfield, CA 94533-6717
Mailing address
2101 Courage Dr
Fairfield, CA 94533-6717
Phone (707) 784-7990
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 |
|---|---|---|---|
| 61306 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1881889186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 COURAGE DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945336717",
"telephone_number": "707-784-7990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 COURAGE DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945336717",
"telephone_number": "707-784-7990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYBURN",
"first_name": "LINDSEY",
"credential": "M.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-10",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "61306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.