KYLE BRENT ODESHA (NPI# 1023621950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023621950 |
| Entity Type | Individual |
| Full Name | KYLE BRENT ODESHA |
| Practice Address |
900 Fulton Ave Sacramento CA 95825-4500 |
| Practice Telephone | 9164843570 |
| Practice Fax Number | 9164843577 |
| Mailing Telephone | 9164843570 |
| Mailing Fax Number | 9164843577 |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172V00000X | Community Health Worker | CA | Other Service Providers | |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
900 FULTON AVE |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95825-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528074770 | Shannan Natalie Taylor | Marriage & Family Therapist | 900 Fulton Ave, 205, Sacramento, CA 95825-4500 | 2006-07-31 |
| 1346869294 | Jessica Sheppard | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2020-04-10 |
| 1013566934 | Alexis Pope | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2019-09-04 |
| 1932754199 | Rebecca Nelson | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2019-08-05 |
| 1689233124 | Rana Ghaemmaghami | Student in an Organized Health Care Education/Training Program | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2019-06-09 |
| 1861960023 | Ryan Dexter Lacy | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2018-11-06 |
| 1780165589 | Jennifer Watson | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2018-08-28 |
| 1922501915 | Andrea May Mahone | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825 | 2018-03-15 |
| 1043739329 | Austin Clinton Smith | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2017-09-18 |
| 1043739014 | Rachel Heiden | Case Manager/Care Coordinator | 900 Fulton Ave, Sacramento, CA 95825-4500 | 2017-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1962009308 | Andrea Isabel Morales | Behavior Technician | 333 University Avenue, Suite 200, Sacramento, CA 95825 | 2020-10-08 |
| 1942810510 | Melissa Marlene Lowndes | Occupational Therapist | 1337 Howe Ave Unit 107, Sacramento, CA 95825 | 2020-08-07 |
| 1780294827 | Travis Elliott Peppers | Case Manager/Care Coordinator | 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 | 2020-08-04 |
| 1154950327 | Hallie Wenz | Behavior Technician | 333 University Ave Suite #200, Sacramento, CA 95825 | 2020-04-08 |
| 1679105456 | Dr. Page Hudson Dental Corporation | Dentist | 1580 Howe Avenue, Suite A, Sacramento, CA 95825 | 2020-02-10 |
| 1710517891 | Amelia Garnica | Community/Behavioral Health | 720 Howe Avenue, Suite 102, Sacamento, CA 95825 | 2020-01-17 |
| 1427697374 | Anthony Barnes | Social Worker | 2008 Morse Avenue, Commons Building, Sacramento, CA 95825 | 2019-12-24 |
| 1528604519 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave., Suite 102, Cacramento, CA 95825 | 2019-11-25 |
| 1164068144 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave. Suite, 102, Sacramento, CA 95825 | 2019-11-25 |
| Find all providers in zip 95825 | ||||
| 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 |
|---|---|---|---|---|
| 1932709458 | Andre Howard | Case Manager/Care Coordinator | 2281 Hurley Way Apt 10, Sacramento, CA 95825-2337 | 2020-10-26 |
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1891392676 | Natalie V Galaviz | Case Manager/Care Coordinator | 3815 Marconi Ave # 52, Sacramento, CA 95821-3867 | 2020-10-05 |
| 1780294827 | Travis Elliott Peppers | Case Manager/Care Coordinator | 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 | 2020-08-04 |
| 1093332579 | David Lynch | Case Manager/Care Coordinator | 700 H St Ste 270, Sacramento, CA 95814-1289 | 2020-06-30 |
| 1770126906 | Chrysanthia D Leggett | Case Manager/Care Coordinator | 7415 Henrietta Dr Unit A, Sacramento, CA 95822-5142 | 2019-10-21 |
| 1558904870 | Larry Carter | Case Manager/Care Coordinator | 3700 Watt Ave Apt 13, Sacramento, CA 95821-2661 | 2019-10-18 |
| 1255982443 | Valerie Bishop | Case Manager/Care Coordinator | 5691 Boyton Way, Sacramento, CA 95823-3811 | 2019-09-27 |
| 1720637689 | Ayana Nuno | Case Manager/Care Coordinator | 1616 El Monte Ave, Sacramento, CA 95815-2903 | 2019-09-04 |
| 1154980597 | Nosazena Leo Uyigue | Case Manager/Care Coordinator | Sacramento County Mental Health Treatment Center, 2150 Stockton Boulevard, Sacramento, CA 95817-1337 | 2019-06-10 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95825 |
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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.