Active NPI
Jessica Erin Jackson, RRT
- Registered Respiratory Therapist
- Modesto, CA
National Provider Identifier
1316281504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Respiratory Therapist
- License
- 32816
- Practice address
- 1700 McHenry Ave
Suite 60B
Modesto, CA 95350-4373 - Phone
- (209) 548-7865
- NPI assigned
- Nov 12, 2012
- Last updated
- Nov 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Respiratory Therapist | 227900000X | 32816 | CA | Primary |
Addresses
Primary practice location
1700 McHenry Ave
Suite 60B
Modesto, CA 95350-4373
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32816 | CA | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1316281504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-521-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 MCHENRY AVE",
"address_2": "SUITE 60B",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504373",
"telephone_number": "209-548-7865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JESSICA",
"middle_name": "ERIN",
"credential": "RRT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-12",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "227900000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered",
"state": "CA",
"license": "32816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.