Jacqueline Say Sevilla, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A87837 Issued in CA

Practice address

81-715 Doctor Carreon Boulevard
Suite a-1
Indio, CA 92201-0601

Phone

(760) 323-9309

Fax

(760) 610-8995

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Clinicas de Salud del Pueblo, Inc

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1346313889
  Medicare reassignment NPD
• Jacqueline Sevilla MD a Medical Corporation

  • Obstetrics & Gynecology Physician
  • Indio, CA
  • NPI 1114301298
  NPD (past) Authorized official
• Clinicas de Salud del Pueblo Inc.

  dba Hemet medical and Dental Center

  • Federally Qualified Health Center (FQHC)
  • Hemet, CA
  • NPI 1033593108
  NPD
• Clinicas de Salud del Pueblo Inc.

  dba InnerCare Pharmacy

  • Community/Retail Pharmacy
  • El Centro, CA
  • NPI 1962045872
  NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1518023209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81-715 DOCTOR CARREON BOULEVARD",
            "address_2": "SUITE A-1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010601",
            "telephone_number": "760-342-2295",
            "fax_number": "760-342-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81-715 DOCTOR CARREON BOULEVARD",
            "address_2": "SUITE A-1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010601",
            "telephone_number": "760-323-9309",
            "fax_number": "760-610-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVILLA",
        "first_name": "JACQUELINE",
        "middle_name": "SAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A87837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0042690",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A878370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesus Alfredo Serrato Vidal, ASW
• Marisela Serrato
• Set Apart Service LLC
• Norman Shigeo Seto, O.D.
• Jude L Seva
• James Shahbakhti, RN
• Gregory Shain, D.D.S.
• Susan Faith Shapiro
• Marjan Sharifi
• Edward Charles Sharp, D.D.S., M.S.

• Obstetrics & Gynecology Physician in Indio, CA
• Providers in Indio, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.