Individual provider Active NPI

Jennifer Vranich

  • Student in an Organized Health Care Education/Training Program
  • Elk Grove, CA
National Provider Identifier
1215520697
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8788 Elk Grove Blvd Ste M
Elk Grove, CA 95624-1768
Phone
(209) 981-9627
NPI assigned
Feb 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

8788 Elk Grove Blvd Ste M
Elk Grove, CA 95624-1768

Mailing address

172 Valparaiso Ave Apt 8
Cotati, CA 94931-4386
Phone (209) 981-9627

Other identifiers 1

IdentifierTypeStateIssuer
94-1694676MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Encrypted

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

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1215520697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 VALPARAISO AVE APT 8",
            "city": "COTATI",
            "state": "CA",
            "postal_code": "949314386",
            "telephone_number": "209-981-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 ELK GROVE BLVD STE M",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241768",
            "telephone_number": "209-981-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VRANICH",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94-1694676",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Encrypted",
            "affiliation": "N",
            "address_1": "2403 Professional Dr Ste 101",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954033007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.