Individual provider Active NPI

Jamie Marie Sanders, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Novato, CA
National Provider Identifier
1407308422
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95010063 Issued in CA
Practice address
6100 Redwood Blvd
Novato, CA 94945-4501
Phone
(415) 448-1500
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X NP95010063 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95010063 CA Primary

Addresses

Primary practice location

6100 Redwood Blvd
Novato, CA 94945-4501

Mailing address

6100 Redwood Blvd
Novato, CA 94945-4501
Phone (415) 448-1500

Other practice location 1

3260 Kerner Blvd
San Rafael, CA 94901-4840
Phone (415) 448-1500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230116000139 CA Practitioner - Nurse Practitioner 7810241692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95010063CAMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Nov 10, 2022 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Interoperability endpoints

  • Direct secure messaging: jsanders585270@direct.ochin.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1407308422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 REDWOOD BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454501",
            "telephone_number": "415-448-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 REDWOOD BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454501",
            "telephone_number": "415-448-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3260 Kerner Blvd",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949014840",
            "country_code": "US",
            "telephone_number": "415-448-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JAMIE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "NP95010063",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95010063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.