Individual provider Active NPI

Jessica Rowe, PSYD

  • Clinical Psychologist
  • Folsom, CA
National Provider Identifier
1124401203
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY30803 Issued in CA
Practice address
750 Oak Avenue Pkwy
Ste 160
Folsom, CA 95630
Phone
(916) 500-4054
Fax
(916) 260-5837
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY30803 CA Primary

Addresses

Primary practice location

750 Oak Avenue Pkwy
Ste 160
Folsom, CA 95630

Mailing address

750 Oak Avenue Pkwy Ste 160
Folsom, CA 95630-6866
Phone (916) 500-4054

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY30803CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1124401203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 OAK AVENUE PKWY STE 160",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306866",
            "telephone_number": "916-500-4054",
            "fax_number": "916-260-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 OAK AVENUE PKWY",
            "address_2": "STE 160",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-500-4054",
            "fax_number": "916-260-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWE",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.