MS. LEE LANI CLARK (NPI# 1790817948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790817948 |
| Entity Type | Individual |
| Full Name | MS. LEE LANI CLARK |
| Practice Address |
2221 Enborg Ln San Jose CA 95128-2608 |
| Practice Telephone | 4088856220 |
| Practice Fax Number | 4088853977 |
| Mailing Telephone | 4088856220 |
| Mailing Fax Number | 4088853977 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053735464 | Lee Ann Clark | Registered Nurse | 15305 Waller Rd E, Tacoma, WA 98446-1533 | 2014-02-06 |
| 1215491048 | Lee Ann Clark | Case Manager/Care Coordinator | 326 W 11th St, Shawnee, OK 74801-6710 | 2019-01-25 |
| 1497899272 | Lee W Clark | Psychiatry & Neurology | 10350 E Dakota Ave, Denver, CO 80247-1314 | 2007-02-16 |
| 1417910860 | Lee A Clark Jr. | Optometrist | 1707 Medical Park Dr W, Wilson, NC 27893-2788 | 2006-04-07 |
| Street Address |
2221 ENBORG LN |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164597167 | Shahbaz Amir Khan | Psychiatry & Neurology | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2006-11-22 |
| 1437756913 | Juan Ramon Zago | Licensed Psychiatric Technician | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2020-10-07 |
| 1295385714 | Lawanda Crystal Avila | Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2019-09-17 |
| 1437616158 | Luis Gilberto Negrete | Rehabilitation Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2019-02-28 |
| 1649784323 | Jessica Delila Martinez | Community Health Worker | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2017-11-17 |
| 1285055020 | Antonio Tabboga | Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-12-20 |
| 1982045019 | William Ikechukwu Eya | Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-07-17 |
| 1922349356 | Edwin Louie | Pharmacist | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-03-11 |
| 1326389701 | Huong Nguyen | Pharmacist | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-03-08 |
| 1346581857 | Dennis Michael Dwyer | Pharmacist | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| 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 |
|---|---|---|---|---|
| 1619592292 | Feng Zheng | Case Manager/Care Coordinator | 298a Bernal Road, San Jose, CA 95119-1809 | 2020-06-10 |
| 1881234375 | Harpreet Kaur | Case Manager/Care Coordinator | 1691 Bagpipe Way, San Jose, CA 95121-1506 | 2020-01-13 |
| 1790321214 | Jesse Schulte | Case Manager/Care Coordinator | 2 N Market St, San Jose, CA 95113-1211 | 2019-11-19 |
| 1386288017 | Path (people Assisting The Homeless) | Case Manager/Care Coordinator | 290 N. 2nd Street San Jose Ca, San Jose, CA 95112 | 2019-11-06 |
| 1154964252 | Darra Lea Velasco | Case Manager/Care Coordinator | 171 N Capitol Ave Apt 4, San Jose, CA 95127-2333 | 2019-10-21 |
| 1851948038 | Xinia Maria Muniz | Case Manager/Care Coordinator | 5066 New Trier Ave, San Jose, CA 95136-2720 | 2019-08-22 |
| 1790246577 | Gary Anduin Garrick | Case Manager/Care Coordinator | 1356 Ridder Park Dr, San Jose, CA 95131-2313 | 2019-03-26 |
| 1972076347 | William Ray Brice | Case Manager/Care Coordinator | 834 Opal Dr Apt 2, San Jose, CA 95117-2662 | 2019-01-08 |
| 1285103697 | Connie Bustillo | Case Manager/Care Coordinator | 1356 Ridder Park Drive, San Jose, CA 95131 | 2018-11-14 |
| 1235605528 | Melissa Ann Morgan | Case Manager/Care Coordinator | 428 N. White Rd., San Jose, CA 95127 | 2018-10-15 |
| Find all providers in SAN JOSE | ||||
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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.