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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DIONETTA CHRISTINE MALLORY
NPI 1053965202
Social Worker - Clinical in Stockton, CA

Active since July 26, 2019PECOS Enrolled
2510 N CALIFORNIA ST, STOCKTON, CA 95204 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 29, 2026, Jul 26, 2019 (2 updates tracked since 2019).

About Dionetta Christine Mallory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIONETTA CHRISTINE MALLORY (NPI 1053965202) is an individual clinical provider in Stockton, California, licensed in California (87217) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Stockton.

NPPES Registry Identity

NPI1053965202
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDIONETTA CHRISTINE MALLORY
Location Address2510 N CALIFORNIA STStockton, CA 95204-5502
Mailing Address2501 N California StStockton, CA 95204-5501 · (209) 620-5358
Sole ProprietorYes
Enumeration DateJuly 26, 2019
Last NPPES UpdateSeptember 29, 20262 updates tracked since enumeration
✔ NPI 1053965202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 87217
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2510 N CALIFORNIA ST, Stockton, CA 95204
Open in Google Maps ↗

Secondary Practice Location 1

Location 12510 N California StStockton, CA 95204-5502 · Phone (209) 620-5358

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dionetta Christine Mallory is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Dionetta Mallory reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Port City Operating Company, LLC
Same address
Psychiatric Hospital
2510 N CALIFORNIA ST
Stockton, CA 95204
  • Reassigned Medicare billing, California enrollment
  • 11 clinicians in this Medicare group
NPI 1053443473 (858) 275-8112

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $58.87 – $176.60
Typical copayment $0.00 (range $14.71 – $44.15)
Most-billed visit code NA
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PORT CITY OPERATING COMPANY, LLC
Psychiatric Hospital
2510 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (858) 275-8112
NAILA KHATTAK IQBAL DO
Student in an Organized Health Care Education/Training Program
2510 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 461-2000
MR. JARED MICHAEL GLORIA
Student in an Organized Health Care Education/Training Program
2510 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 938-0831
MR. MICHAEL C BELLO LCSW
Social Worker (Clinical)
2510 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 461-2000
MRS. SUSAN KATHLEEN MARTIN MFTI
Marriage & Family Therapist
2510 N CALIFORNIA ST
STOCKTON, CA 95204
San Joaquin County (209) 461-2027

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dionetta Mallory's NPI number?

The NPI number for Dionetta Mallory is 1053965202. It was assigned to this individual provider in the NPPES registry on July 26, 2019.

Where is Dionetta Mallory located?

Dionetta Mallory practices at 2510 N California St, Stockton, CA 95204.

What is Dionetta Mallory's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Dionetta Mallory enrolled in Medicare?

Yes. Dionetta Mallory is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Dionetta Mallory's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dionetta Mallory reassigns Medicare benefits to Port City Operating Company, LLC (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dionetta Mallory's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dionetta Mallory accept?

Health plans from HMSA list Dionetta Mallory as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dionetta Mallory was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.