Individual provider Active NPI

Jayne Lacy

  • Hospice Registered Nurse
  • Oakland, CA
National Provider Identifier
1063187250
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice Registered NurseTaxonomy code 163WH1000X
License
820767 Issued in CA
Practice address
5707 Redwood Rd Ste 11
Oakland, CA 94619-2400
Phone
(312) 342-5638
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X 820767 CA Primary

Addresses

Primary practice location

5707 Redwood Rd Ste 11
Oakland, CA 94619-2400

Mailing address

5707 Redwood Rd Ste 11
Oakland, CA 94619-2400
Phone (312) 342-5638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
820767CAMDHospice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1063187250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 REDWOOD RD STE 11",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946192400",
            "telephone_number": "312-342-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 REDWOOD RD STE 11",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946192400",
            "telephone_number": "312-342-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "JAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "CA",
            "license": "820767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.