Amy Jacobson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5750 Sunrise Blvd Ste 210B
Citrus Heights, CA 95610-7639

Phone

(916) 794-2326

NPI assigned

Jul 17, 2019

Last updated

Jul 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Olive Branch Autism Services

  • Behavior Analyst
  • Citrus Heights, CA
  • NPI 1124596390
  NPD (past)

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1386297596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 SUNRISE BLVD STE 210B",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 SUNRISE BLVD STE 210B",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107639",
            "telephone_number": "916-794-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shomari Jackson
• Tsekani Jackson
• Daniel Larsen Jacobs, DO
• Jordan Nichole Jacobs
• Kaylee Lynn Jacobsen
• Kerri Alexis Jacobson
• Dylan Richard Jake
• Carlisa James
• Leila Michelle Jamshidi, DDS
• Weonsuk Jang, DMD

• Behavior Technician in Citrus Heights, CA
• Providers in Citrus Heights, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.