Individual provider Active NPI

Jennifer Anne Anderson, RN

  • Doula
  • Davis, CA
National Provider Identifier
1568148609
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
4511 San Marino Dr
Davis, CA 95618-5014
Phone
(530) 902-3396
NPI assigned
Jun 23, 2023
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 633849 CA
Doula 374J00000X Primary

Addresses

Primary practice location

4511 San Marino Dr
Davis, CA 95618-5014

Mailing address

4511 San Marino Dr
Davis, CA 95618-5014
Phone (530) 902-3396

Other practice location 1

6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone (916) 688-2000

Other practice location 2

4301 X St
Sacramento, CA 95817-2214
Phone (916) 734-2011

Other practice location 3

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 887-0000

Other practice location 4

1325 Cottonwood St
Woodland, CA 95695-5131
Phone (530) 662-3961

Other practice location 5

1600 Eureka Rd
Roseville, CA 95661-3027
Phone (916) 784-4000

Other practice location 6

2000 Sutter Pl
Davis, CA 95616-6201
Phone (530) 759-7444

Other practice location 7

1 Quality Dr
Vacaville, CA 95688-9494
Phone (707) 624-4000

Other identifiers 1

IdentifierTypeStateIssuer
633849OtherCACA BOARD OF REGISTERED NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
633849CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1568148609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 SAN MARINO DR",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956185014",
            "telephone_number": "530-902-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 SAN MARINO DR",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956185014",
            "telephone_number": "530-902-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 Bruceville Rd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958234671",
            "country_code": "US",
            "telephone_number": "916-688-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 X St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172214",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2825 Capitol Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958166039",
            "country_code": "US",
            "telephone_number": "916-887-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "956955131",
            "country_code": "US",
            "telephone_number": "530-662-3961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Eureka Rd",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956613027",
            "country_code": "US",
            "telephone_number": "916-784-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Sutter Pl",
            "address_purpose": "LOCATION",
            "city": "Davis",
            "state": "CA",
            "postal_code": "956166201",
            "country_code": "US",
            "telephone_number": "530-759-7444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Quality Dr",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956889494",
            "country_code": "US",
            "telephone_number": "707-624-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "633849",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF REGISTERED NURSING",
            "identifier": "633849",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.