Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Eboni Maxwell

Case Manager/Care Coordinator β€’ Vallejo, CA

Active NPI 1609422740 Individual Practitioner Female Practitioner
Practice location in NPPES

1119 Kentucky St
Vallejo, CA 945905201

Call 4158796071 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1119 Kentucky St

Vallejo, CA 945905201

Telephone 4158796071

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Vallejo and California

46 active clinicians are listed under Case Manager/Care Coordinator with a practice address in Vallejo, CA (22,844 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Vallejo

0% of these 46 clinicians have the CMS telehealth indicator.

0% of these 46 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-09-27
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

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.

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Community Health Worker

NUCC Taxonomy Code: 172V00000X

Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
πŸ“
Updated Practice Location September 27, 2024

Registered at 1119 KENTUCKY ST, VALLEJO, CA 945905201 (Tel: 4158796071)

πŸ“
Updated Business Mailing Address September 27, 2024

Registered at 1119 KENTUCKY ST, VALLEJO, CA 945905201 (Tel: 4158796071)

πŸ“
Updated Practice Location May 15, 2023

Registered at 1234 EMPIRE ST, FAIRFIELD, CA 945335711 (Tel: 5103171444)

πŸ“
Updated Business Mailing Address May 15, 2023

Registered at 1234 EMPIRE ST, FAIRFIELD, CA 945335711 (Tel: 5103171444)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 15, 2023

Counselor

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 29, 2022

Community Health Worker

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 12, 2021

Counselor

βœ…
NPI Profile Active August 14, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 14, 2019

Registered at 2275 ARLINGTON DR, SAN LEANDRO, CA 945781132 (Tel: 5103171444)

πŸ“
Business Mailing Address (Initial Record) August 14, 2019

Registered at 2275 ARLINGTON DR, SAN LEANDRO, CA 945781132 (Tel: 5103171444)

πŸ‘€
Provider Name / Credentials (Initial Record) August 14, 2019

Recorded as EBONI MAXWELL

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2019

Counselor

🟒
Initial NPI Registration & Enumeration August 14, 2019

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1609422740
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 14, 2019
Last Update: September 27, 2024
Sole Proprietor: No

Mailing Address

1119 Kentucky St

Vallejo, CA 945905201

Phone: 4158796071

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.