Individual provider Active NPI

Jennifer Olenchuk, RN BSN MMCP

  • Medical-Surgical Registered Nurse
  • Jackson, CA
National Provider Identifier
1497634117
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
827534 Issued in CA
Practice address
200 Mission Blvd
Jackson, CA 95642-2564
Phone
(916) 220-3625
NPI assigned
Aug 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 827534 CA Primary

Addresses

Primary practice location

200 Mission Blvd
Jackson, CA 95642-2564

Mailing address

12501 New York Ranch Rd
Jackson, CA 95642-9553
Phone (916) 220-3625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
827534CAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1497634117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429553",
            "telephone_number": "916-220-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MISSION BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422564",
            "telephone_number": "916-220-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLENCHUK",
        "first_name": "JENNIFER",
        "credential": "RN BSN MMCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "827534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.