Active NPI
Rebecca Jackson
- Occupational Therapist
- Clovis, CA
National Provider Identifier
1588085963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19219
- Practice address
- 606 N Magnolia Ave
Clovis, CA 93611-9206 - Phone
- (559) 321-8162
- Fax
- (559) 472-3559
- NPI assigned
- Jan 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 19219 | CA | Primary |
Addresses
Primary practice location
606 N Magnolia Ave
Clovis, CA 93611-9206
Mailing address
701 W Center Ave
Visalia, CA 93291-6015
Phone (559) 713-6806
Other practice location 1
175 Deer Run Rd
Danville, VA 24540-2863
Phone (434) 797-5531
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1588085963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 W CENTER AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932916015",
"telephone_number": "559-713-6806",
"fax_number": "559-713-6809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 N MAGNOLIA AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936119206",
"telephone_number": "559-321-8162",
"fax_number": "559-472-3559"
}
],
"practiceLocations": [
{
"address_1": "175 Deer Run Rd",
"address_purpose": "LOCATION",
"city": "Danville",
"state": "VA",
"postal_code": "245402863",
"country_code": "US",
"telephone_number": "434-797-5531",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-02",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "19219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.