Individual provider Active NPI

Jaclyn Michelle Fox, PHD

  • Clinical Neuropsychologist
  • Sacramento, CA
National Provider Identifier
1548716962
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY33644 Issued in CA
Practice address
3160 Folsom Blvd Ste 1400
Sacramento, CA 95816-5263
Phone
(916) 731-1831
NPI assigned
Aug 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY33644 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3160 Folsom Blvd Ste 1400
Sacramento, CA 95816-5263

Mailing address

3160 Folsom Blvd Ste 1400
Sacramento, CA 95816-5263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202002340 CA Practitioner - Clinical Psychologist 7810366432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 University Ave
Suite 220
Sacramento, CA 95825-6525
Phone (916) 734-2011

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY33644CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Oct 10, 2022 Accepting new patients
Regents of the University of California CurrentSince Oct 10, 2022 Accepting new patients

Locations

3160 Folsom Blvd
Ste 1400
Sacramento, CA 95816
Phone (916) 731-1831

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1548716962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD STE 1400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD STE 1400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165263",
            "telephone_number": "916-731-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "JACLYN",
        "middle_name": "MICHELLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY33644",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.