NPIMap

Organization Active NPI

Jesse Wade Therapy Inc.

  • Adult Mental Health Clinic/Center
  • Sacramento, CA
National Provider Identifier
1376299032
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
JESSE WADE THERAPY INC.
Practice address
2001 N St Ste 100
Sacramento, CA 95811-4237
Phone
(916) 616-4505
NPI assigned
Feb 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Jesse Wade, PSYDNPI 1194159897
Title
President
Phone
(916) 616-4504

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2001 N St Ste 100
Sacramento, CA 95811-4237

Mailing address

2001 N St Ste 100
Sacramento, CA 95811-4237
Phone (916) 616-4505

Other identifiers 1

IdentifierTypeStateIssuer
1194159897OtherCAOTHER AGENCY

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Computer Direct
CONNECT URL Computer Direct

National Provider Directory

National Provider Directory

Locations

2001 N St
Ste 100
Sacramento, CA 95811
Phone (916) 538-2477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1376299032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958114237",
            "telephone_number": "916-616-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958114237",
            "telephone_number": "916-616-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSE WADE THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-616-4504",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER AGENCY",
            "identifier": "1194159897",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2001 N St Ste 100",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958114237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2001 N St Ste 100",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958114237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 22, 2022; 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.