STACY PEDERSON (NPI# 1346663796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346663796 |
| Entity Type | Individual |
| Full Name | STACY PEDERSON |
| Practice Address |
20 W Bedford Ave Clovis CA 93611-3515 |
| Practice Telephone | 5599400385 |
| Mailing Telephone | 5599400385 |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | IMF 71954 INTERN | CA | Other Service Providers |
| Street Address |
20 W BEDFORD AVE |
| City | CLOVIS |
| State | CA |
| Zip Code | 93611-3515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773122 | Mao Thao | Pharmacist | 2133 Shaw Avenue, Clovis, CA 93611 | 2019-04-24 |
| 1326506098 | Lauren Moriah Horsley | Speech-Language Pathologist | 650 W. Alluvial Ave., Clovis, CA 93611 | 2019-03-12 |
| 1780171223 | Alamos Care | Skilled Nursing Facility | 2193 Alamos Ave, Clovis, CA 93611 | 2018-04-19 |
| 1346612215 | Aimee Rasch | Occupational Therapy Assistant | 650 West Alluvial Avenue, Clovis, CA 93611 | 2015-10-30 |
| 1356778302 | Jonathan Crosby | Physician Assistant | 729 N Medical Center Drive West Suite 101, Clovis, CA 93611 | 2013-10-07 |
| 1093142697 | Stacey Melissa Montes | Nurse Practitioner | 729 N Medical Ctr Dr West, Suite 205, Clovis, CA 93611 | 2013-09-27 |
| 1538594163 | Carly Bren Lepp | Physician Assistant | 2006 Shaw Avenue, Clovis, CA 93611 | 2013-09-13 |
| 1811246150 | Vishal Arya | Pharmacist | 2518 Austin Ave, Clovis, CA 93611 | 2012-08-31 |
| 1669757209 | Kiran V Atwal | Pharmacist | 1815 Herndon Ave--walgreens, Clovis, CA 93611 | 2011-10-14 |
| 1952615957 | Weight Away | Nutritionist | 1895 Herndon Ave, Suite 105, Clovis, CA 93611 | 2010-08-02 |
| Find all providers in zip 93611 | ||||
| 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 |
|---|---|---|---|---|
| 1891879755 | Sarah Renee Bailey | Case Manager/Care Coordinator | 1100 W 21st, Clovis, NM 88101 | 2006-10-25 |
| 1760566681 | Jena Dawn Henry | Case Manager/Care Coordinator | 1100 21st St, Clovis, NM 88101 | 2006-10-25 |
| 1982788840 | Richard Lucero | Case Manager/Care Coordinator | 300 E 5th Street, Clovis, NM 88101 | 2006-10-25 |
| 1750996369 | Wendy Salomon | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-09-10 |
| 1760097372 | Cynthia Cicero | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-09-10 |
| 1275145377 | Tiffany Marie Wright | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-08-19 |
| 1487266623 | Enrique Eliseo Cabral | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-08-19 |
| 1891306288 | Kaitlyn Rael | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-08-11 |
| 1437760824 | Clay Enderez | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-08-11 |
| 1477162683 | Gema Villanueva | Case Manager/Care Coordinator | 1100 W 21st St, Clovis, NM 88101-4151 | 2020-07-24 |
| Find all providers in CLOVIS | ||||
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| 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.