Individual provider Active NPI

Annette Marie Sisley, LCSW

  • Clinical Social Worker
  • Valley Springs, CA
National Provider Identifier
1922903863
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW29017 Issued in CA
Practice address
4159 Hartvickson LN
Valley Springs, CA 95252-8786
Phone
(209) 256-9491
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW29017 CA Primary

Addresses

Primary practice location

4159 Hartvickson LN
Valley Springs, CA 95252-8786

Mailing address

4159 Hartvickson LN
Valley Springs, CA 95252-8786
Phone (209) 256-9491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1922903863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4159 HARTVICKSON LN",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952528786",
            "telephone_number": "209-256-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 HARTVICKSON LN",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952528786",
            "telephone_number": "209-256-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISLEY",
        "first_name": "ANNETTE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW29017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.