Jacqueline Abdalla, M.D.
Individual provider Active NPI Family Medicine Physician · Sacramento, CA
NPI 1376937557 · NPPES record last updated Oct 8, 2025
Key facts
- NPI
- 1376937557
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A145419 (CA)
- Practice address
- 651 I St
Sacramento, CA 95814-2400 - Phone
- (916) 875-7195
- NPI assigned
- Mar 25, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190117003831 | CA | Practitioner - Family Practice | 3274879812 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A145419 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Sacramento | Current |
Accepting new patients | |
| County of Sacramento | Current |
Accepting new patients |
Locations
4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670
4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670
4600 Broadway
Ste 1100
Sacramento, CA 95820
Phone (916) 874-9394
Interoperability endpoints
- jabdalla255096@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A145419 | CA | Yes |
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
12500 Bruceville Rd
Elk Grove, CA 95757-9784
Phone (916) 874-1927
Other practice location 2
4600 Broadway
Sacramento, CA 95820-1527
Phone (916) 875-5881
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A145419 | Other | CA | STATE MEDICAL LICENSE |
Other providers in Sacramento, CA
- Abc Group Healthcare LLC
- Isaiah Abcede
- Abdullah Abdali
- Geeti Abdali
- Pamela Ann Abdali
- Amani Abdallah
- Giacomo Abdallah
- Nazanin Abdehoo
- Marian Abdel Malek
- Mourad Michel Abdel-Malek
All providers in Sacramento, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.