Individual provider Active NPI

Jill Jacoy

  • Pharmacy Technician
  • Stockton, CA
National Provider Identifier
1326312679
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
6673 Issued in CA
Practice address
1212 N California St
Stockton, CA 95202-1552
Phone
(209) 468-8711
NPI assigned
Mar 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 6673 CA Primary

Addresses

Primary practice location

1212 N California St
Stockton, CA 95202-1552

Mailing address

2518 Bayberry Dr
Lodi, CA 95242-4607
Phone (209) 333-8541

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
6673CAMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1326312679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 BAYBERRY DR",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424607",
            "telephone_number": "209-333-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-468-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOY",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "6673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.

Verify at the official NPI Registry.