MR. JACK DAVID SEGEL (NPI# 1275927030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275927030 |
| Entity Type | Individual |
| Full Name | MR. JACK DAVID SEGEL |
| Other Name | MR. JACK DAVID SEGEL |
| Credential | MSW |
| Practice Address |
564 Dora St. Ste.d Ukiah CA 95482 |
| Practice Telephone | 7074720362 |
| Practice Fax Number | 7074720121 |
| Mailing Telephone | 7074720362 |
| Mailing Fax Number | 7074720121 |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
CA | Behavioral Health & Social Service Providers | |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
564 DORA ST. STE.D |
| City | UKIAH |
| State | CA |
| Zip Code | 95482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| 1679998439 | Aurelie Carine Clivaz | Case Manager/Care Coordinator | 776 So. State St., Suite 107, Ukiah, CA 95482 | 2014-03-03 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962012591 | Keith Wayne Driver | Case Manager/Care Coordinator | 610 N State St, Ukiah, CA 95482-4027 | 2020-08-07 |
| 1366932774 | Nicole L Dunaway | Case Manager/Care Coordinator | 376 E Gobbi St Ste B376e, Ukiah, CA 95482-5511 | 2018-05-11 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1679998439 | Aurelie Carine Clivaz | Case Manager/Care Coordinator | 776 So. State St., Suite 107, Ukiah, CA 95482 | 2014-03-03 |
| 1841489903 | Kelly Rene Johnson | Case Manager/Care Coordinator | 727 S. State Street, Ukiah, CA 95482 | 2007-10-15 |
| 1396952123 | Troyle Tognoli | Case Manager/Care Coordinator | 727 S State St, Ukiah, CA 95482-5815 | 2007-05-17 |
| 1255478442 | Harvey Baumoel | Case Manager/Care Coordinator | 631 S Orchard Ave, Ukiah, CA 95482-5011 | 2007-01-30 |
| 1497362941 | Fernando Fuentes | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-09-29 |
| 1063027308 | Rebecca Lynn Keswick | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-09-14 |
| 1568074961 | Berenise Cortez Preciado | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-08-18 |
| Find all providers in UKIAH | ||||
Please comment or provide details below to improve the information on MR. JACK DAVID SEGEL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.