Individual provider Active NPI

Jacqueline Abdalla, M.D.

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1376937557
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A145419 Issued in CA
Practice address
651 I St
Sacramento, CA 95814-2400
Phone
(916) 875-7195
NPI assigned
Mar 25, 2015
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A145419 CA Primary

Addresses

Primary practice location

651 I St
Sacramento, CA 95814-2400

Mailing address

651 I St
Sacramento, CA 95814-2400
Phone (916) 875-7195

Other practice location 1

4600 Broadway
Sacramento, CA 95820-1527
Phone (916) 875-5881

Other practice location 2

12500 Bruceville Rd
Elk Grove, CA 95757-9784
Phone (916) 874-1927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190117003831 CA Practitioner - Family Practice 3274879812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A145419CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sacramento CurrentSince Jan 1, 2019 Accepting new patients
County of Sacramento CurrentSince Jan 1, 2019 Accepting new patients

Locations

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
Ste 1100
Sacramento, CA 95820
Phone (916) 874-9670

Interoperability endpoints

  • Direct secure messaging: jabdalla255096@direct.ochin.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1376937557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 I ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958142400",
            "telephone_number": "916-875-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 I ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958142400",
            "telephone_number": "916-875-7195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Broadway",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958201527",
            "country_code": "US",
            "telephone_number": "916-875-5881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12500 BRUCEVILLE RD",
            "address_purpose": "LOCATION",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957579784",
            "country_code": "US",
            "telephone_number": "916-874-1927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDALLA",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A145419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.