Individual provider Active NPI

Jessica Mauricio Marcos

  • Technician/Technologist
  • Sacramento, CA
National Provider Identifier
1083295067
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Technician/TechnologistTaxonomy code 156F00000X
License
RBT-21-164637 Issued in CA
Practice address
2035 Hurley Way Ste 290
Sacramento, CA 95825-3221
Phone
(916) 758-9768
Fax
(916) 550-1124
NPI assigned
Apr 20, 2021
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician/Technologist 156F00000X RBT-21-164637 CA Primary

Addresses

Primary practice location

2035 Hurley Way Ste 290
Sacramento, CA 95825-3221

Mailing address

2035 Hurley Way Ste 290
Sacramento, CA 95825-3221
Phone (916) 758-9768

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
RBT-21-164637CAMDTechnician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Education Solutions PastSince Apr 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1083295067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 HURLEY WAY STE 290",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253221",
            "telephone_number": "916-758-9768",
            "fax_number": "916-550-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 HURLEY WAY STE 290",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253221",
            "telephone_number": "916-758-9768",
            "fax_number": "916-550-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO MARCOS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "CA",
            "license": "RBT-21-164637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.