4TH Second

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

4TH SECOND

Practice address

929 Amador St
Vallejo, CA 94590-4606

Phone

(707) 335-0300

NPI assigned

Jan 6, 2023

Last updated

Jan 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Emily Fisher, MDNPI 1467848903

Title

Director of Community Health

Phone

(530) 574-4847

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily Fisher

  • Family Medicine Physician
  • Vallejo, CA
  • NPI 1467848903
  NPD Authorized official

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1992419709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 VALLE VISTA AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945903542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 AMADOR ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904606",
            "telephone_number": "707-335-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4TH SECOND",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "DIRECTOR OF COMMUNITY HEALTH",
        "authorized_official_telephone_number": "530-574-4847",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Theresa Abatayo, PHARMD

• Case Manager/Care Coordinator in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.