Jennifer Susan Churchill

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

JPGCUTBYWRQIXHOS Issued in CA

Practice address

2750 Sutterville Rd
Sacramento, CA 95820-1093

Phone

(916) 290-8233

NPI assigned

Jan 18, 2010

Last updated

Apr 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Fields Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1518298330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 SUTTERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201093",
            "telephone_number": "916-290-8233",
            "fax_number": "916-388-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 SUTTERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201093",
            "telephone_number": "916-290-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "JENNIFER",
        "middle_name": "SUSAN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "JPGCUTBYWRQIXHOS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FIELDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Chuong
• Mimi Chuong
• Alyssa Marie Church
• Galen Church, D.O.
• Jason Church, M.A., BCBA
• Paige Marigold Churchill, MSN
• Tatyana Chursina, P.A.
• CHW Children's Center South
• CHW Medical Foundation (Mercy Imaging Centers, a Service of CHW Medical Foundation)
• CHW MF

• Peer Specialist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.