Glen Alan Jett, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

803762 Issued in CA

Practice address

2800 L St
Sacramento, CA 95816-5616

Phone

(510) 266-2996

NPI assigned

Feb 27, 2024

Sex

Male

Sole proprietor

Yes

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1508622507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 REDWOOD DR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204036",
            "telephone_number": "925-349-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "510-266-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT",
        "first_name": "GLEN",
        "middle_name": "ALAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "803762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Holliday MD Inc
• Jessica Huynh OD PC
• Karys Jessie
• Phayth Jessie
• Renee CL Jessup, LCSW
• Demetrius Anthony Jetton-Dennard
• Kerynn Elizabeth Jetton, CD, CPD, LCA
• Kyle Jewett
• Lilyanne Jewett, MD
• Jewish Family Service of Sacramento

• Administrator Registered Nurse in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Administrator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.