Jaclyn Sabanovich, FNP-C

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

F07180575 Issued in CA

Practice address

2216 Buenaventura Blvd
Redding, CA 96001-3838

Phone

(530) 338-0002

NPI assigned

Nov 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• California Family Medical Group Inc

  • Family Medicine Physician
  • Redding, CA
  • NPI 1275001075

  CA, Multi-Specialty

  Medicare reassignment NPD
• Robert C. Fox, M.D. Inc.

  • Ophthalmology Physician
  • Redding, CA
  • NPI 1508084658

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1487124657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 BUENAVENTURA BLVD STE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013838",
            "telephone_number": "530-338-0002",
            "fax_number": "530-768-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 BUENAVENTURA BLVD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013838",
            "telephone_number": "530-338-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABANOVICH",
        "first_name": "JACLYN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F07180575",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "F07180575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Edward Ryan
• Kim Marie Rychetsky, ACSW
• Samantha Ryder
• S P O T, Inc.
• Azin Saadat, MD
• Farzad H Sabet, MD
• Victor O Sabo, MD
• James J Sacco
• Bradley Sackfield
• Madison Saddoris, DPT

• All providers in Redding, CA
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.