Active NPI
Jennifer Fallman
- Social Worker
- McClellan, CA
National Provider Identifier
1891968418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 5342 Dudley Blvd
Mail Code 116
McClellan, CA 95652-1012 - Phone
- (916) 561-7461
- Fax
- (916) 561-7461
- NPI assigned
- Apr 3, 2008
- Reactivated
- Oct 3, 2013
- Last updated
- Oct 18, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
5342 Dudley Blvd
Mail Code 116
McClellan, CA 95652-1012
Mailing address
5342 Dudley Blvd
Mail Code 116
McClellan, CA 95652-1012
Phone (916) 561-7461
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382054400000",
"number": "1891968418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5342 DUDLEY BLVD",
"address_2": "MAIL CODE 116",
"city": "MCCLELLAN",
"state": "CA",
"postal_code": "956521012",
"telephone_number": "916-561-7461",
"fax_number": "916-561-7471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5342 DUDLEY BLVD",
"address_2": "MAIL CODE 116",
"city": "MCCLELLAN",
"state": "CA",
"postal_code": "956521012",
"telephone_number": "916-561-7461",
"fax_number": "916-561-7461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLMAN",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-03",
"last_updated": "2013-10-18",
"deactivation_date": "2011-02-02",
"reactivation_date": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McClellan, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.