MARGARET PETTIBONE (NPI# 1891218442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891218442 |
| Entity Type | Individual |
| Full Name | MARGARET PETTIBONE |
| Practice Address |
545 Estudillo Ave San Leandro CA 94577-4611 |
| Mailing Address |
220 El Cerrito Ave Piedmont CA 94611-4121 |
| Practice Telephone | 5107467480 |
| Mailing Telephone | 4019353366 |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-07-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
545 ESTUDILLO AVE |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94577-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205992096 | Subacute Treatment for Adolescent Rehabilitation Services, Inc. | Community/Behavioral Health | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2006-12-28 |
| 1205436334 | Gerald Michael Bejarin | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-10-28 |
| 1174120992 | Stars Behavioral Health Group | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-10-05 |
| 1043827504 | Cindy Gutierrez | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-09-29 |
| 1295342129 | Renika Renee Buttigieg | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-09-24 |
| 1457967242 | Joshua Crum | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-09-17 |
| 1003421041 | Maren Elizabeth Trotter | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-09-15 |
| 1558976324 | Katherine Macarthur Walker | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-09-09 |
| 1396357695 | Jonathan Walden Leonard | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-08-18 |
| 1902423353 | Megan A Davis | Counselor | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2020-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093358574 | A Caring Heart Home Health Inc. | In Home Supportive Care | 215-237 Estudillo Ave, Suite 202, San Leandro, CA 94577 | 2019-10-28 |
| 1871070052 | New Connections Neuropsychology, PC | Clinical Neuropsychologist | 1057 Macarthur Blvd, Ste 214, San Leandro, CA 94577 | 2018-07-20 |
| 1790287266 | Jennifer Capilla | Behavior Technician | 333 Estudillo Ave #204, San Leandro, CA 94577 | 2018-03-01 |
| 1891296760 | Maryann Kruse Bens | Clinical Neuropsychologist | 1057 Macarthur Blvd Ste 214, San Leandro, CA 94577 | 2018-02-26 |
| 1811406721 | Brendon Hoang Nguyen | Dentist | 145 E 14th St, San Leandro, CA 94577 | 2017-09-22 |
| 1801311774 | Calvin Walker | Counselor | 3801 Teagarden Street, San Leandro, CA 94577 | 2017-08-11 |
| 1184154999 | Shauntrinae Mason | Marriage & Family Therapist | 1000 San Leandro Blvd., Suite 300, San Leandro, CA 94577 | 2017-06-14 |
| 1912453135 | Dr. Marshea Evans | Point of Service | 1068 E14th Street, San Leandro, CA 94577 | 2016-08-28 |
| 1902252935 | Mobility Express Medical Transportation | Non-emergency Medical Transport (VAN) | 1695 Abram Ct Ste 202, San Leandro, CA 94577 | 2016-05-09 |
| 1194170381 | Girls Incorporated of Alameda County | Community/Behavioral Health | 2251 Bancroft Ave, San Leandro, CA 94577 | 2016-04-26 |
| Find all providers in zip 94577 | ||||
| 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 |
|---|---|---|---|---|
| 1255972485 | Jessica Jasmin Ibarra | Case Manager/Care Coordinator | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2019-09-29 |
| 1871067462 | Han A Jung | Case Manager/Care Coordinator | 101 Callan Ave Ste 400, San Leandro, CA 94577-4523 | 2019-01-16 |
| 1588135321 | Alejandra Acosta | Case Manager/Care Coordinator | 16110 E 14th St, San Leandro, CA 94578-3002 | 2018-12-05 |
| 1962984088 | Cynthia Diane Kaufman | Case Manager/Care Coordinator | 13847 E 14th St Ste 205, San Leandro, CA 94578-2626 | 2018-09-05 |
| 1972013035 | Alan Sanchez Jorge | Case Manager/Care Coordinator | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2017-10-03 |
| 1750832440 | Axel Bulutoglu | Case Manager/Care Coordinator | 545 Estudillo Ave, San Leandro, CA 94577-4611 | 2016-10-18 |
| 1346662491 | Falilah Bilal | Case Manager/Care Coordinator | 16378 E 14th St, San Leandro, CA 94578-5120 | 2014-01-09 |
| 1386908036 | Kaireece Allen | Case Manager/Care Coordinator | 2035 Fairmont Dr, San Leandro, CA 94578-1088 | 2012-06-27 |
| 1265796916 | Latisha Cummings | Case Manager/Care Coordinator | 2035 Fairmont Dr, San Leandro, CA 94578-1088 | 2012-06-27 |
| 1609130368 | Victoria Wall | Case Manager/Care Coordinator | 2035 Fairmont Dr, San Leandro, CA 94578-1088 | 2012-06-27 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94577 |
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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.