Individual provider Active NPI

Lise Williams-Johnson

  • Case Manager/Care Coordinator
  • Moreno Valley, CA
National Provider Identifier
1881984458
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
13800 Heacock St
Suite C236
Moreno Valley, CA 92553-3339
Phone
(951) 653-0819
NPI assigned
Apr 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

13800 Heacock St
Suite C236
Moreno Valley, CA 92553-3339

Mailing address

382 Minaret St
Corona, CA 92881-0986
Phone (951) 427-0379

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1881984458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 MINARET ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928810986",
            "telephone_number": "951-427-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 HEACOCK ST",
            "address_2": "SUITE C236",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533339",
            "telephone_number": "951-653-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-JOHNSON",
        "first_name": "LISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.