LYNNGENIA CARRUTH (NPI# 1821456658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821456658 |
| Entity Type | Individual |
| Full Name | LYNNGENIA CARRUTH |
| Practice Address |
1735 Enterprise Dr Suite 105a Fairfield CA 94533-6822 |
| Practice Telephone | 7074251799 |
| Practice Fax Number | 7074251081 |
| Mailing Telephone | 7074251799 |
| Mailing Fax Number | 7074251081 |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
1735 ENTERPRISE DR SUITE 105A |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-6822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679779482 | Zaida Mungaray | Counselor | 1735 Enterprise Dr, 205d, Fairfield, CA 94533-6822 | 2007-06-27 |
| 1518441773 | Darcy Ann Young | Marriage & Family Therapist | 1735 Enterprise Dr, Fairfield, CA 94533-6822 | 2018-09-23 |
| 1770097370 | Cheauvon Latrice Brown | Counselor | 1735 Enterprise Dr, Fairfield, CA 94533-6822 | 2017-11-20 |
| 1669907234 | Diana Ahumada | Counselor | 1735 Enterprise Dr, Building 1 Suite 105 A, Fairfield, CA 94533-6822 | 2017-04-20 |
| 1730611443 | Sabrina Waldron | Counselor | 1735 Enterprise Dr, Bldg 1 Suite 105a, Fairfield, CA 94533-6822 | 2017-03-31 |
| 1932649589 | Keith Davis | Counselor | 1735 Enterprise Dr, Fairfield, CA 94533-6822 | 2017-03-01 |
| 1376901116 | Marisol Barber | Counselor | 1735 Enterprise Dr, Suite 105a, Fairfield, CA 94533-6822 | 2016-02-08 |
| 1952768863 | Amanda Emmons | Counselor | 1735 Enterprise Dr, Suite 105a, Fairfield, CA 94533-6822 | 2016-01-22 |
| 1043677982 | Chelsey Mcdonald | Counselor | 1735 Enterprise Dr, Suite 105a, Fairfield, CA 94533-6822 | 2016-01-22 |
| 1194190314 | Lori Weisenburg | Counselor | 1735 Enterprise Dr, Suite 105a, Fairfield, CA 94533-6822 | 2015-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700411386 | Darren Hailey | Counselor | 72 Villa Cir, Fairfield, CA 94533-2523 | 2020-03-04 |
| 1013567270 | Asia Robinson | Counselor | 1165 Dove Way, Fairfield, CA 94533-2542 | 2019-09-18 |
| 1689220477 | Carl Leonard Fessenden | Counselor | 1974 Winchester Pl, Fairfield, CA 94533-3618 | 2019-08-16 |
| 1598262677 | Jason Michael Levline | Counselor | 5266 Charlene Ave, Fairfield, OH 45014-1535 | 2018-04-06 |
| 1497285084 | Beth A. Bronfman | Counselor | 87 Fairfield Rd, Fairfield, NJ 07004-2546 | 2017-06-15 |
| 1588191290 | Kirk D. Condon | Counselor | 201 South 23rd, Fairfield, IA 52556 | 2017-05-12 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1730639329 | Jonathon Grogan | Counselor | 2480 Hilborn Rd, Fairfield, CA 94534-1856 | 2016-10-07 |
| 1295119196 | Sara Faye Jones | Counselor | 745 Ohio St Apt 2, Fairfield, CA 94533-6222 | 2015-07-10 |
| 1205242583 | Amy Lynn Davis | Counselor | 620 Julmar Cir, Fairfield, CA 94534-4214 | 2014-07-07 |
| Find all providers in FAIRFIELD | ||||
Please comment or provide details below to improve the information on LYNNGENIA CARRUTH.
| 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.