Jenny Lynn Bills, SUDRC #14244

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

39007BN Issued in CA

Practice address

1981 Cherokee Rd
Stockton, CA 95205-2720

Phone

(209) 870-6500

NPI assigned

Nov 14, 2022

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

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.

• Alcohol & Drug Awareness Program

  • Substance Abuse Rehabilitation Facility
  • Stockton, CA
  • NPI 1467298505
  NPD
• Alcohol & Drug Awareness Program

  • Substance Abuse Rehabilitation Facility
  • Stockton, CA
  • NPI 1386123719
  NPD (past)

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1558079954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 CHEROKEE RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952052720",
            "telephone_number": "209-870-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 CHEROKEE RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952052720",
            "telephone_number": "209-870-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLS",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "credential": "SUDRC #14244",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "39007BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Stockton, CA
• Providers in Stockton, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.