Jake Anthony Peccia, RN, BSN, EMT-P

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

768702 Issued in CA

Practice address

2150 Stockton Blvd
Sacramento, CA 95817-1337

Phone

(916) 752-2455

NPI assigned

Jun 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Emergency Medical Technician - Paramedic, Registered Nurse

State licenses

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1598029415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171337",
            "telephone_number": "916-752-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171337",
            "telephone_number": "916-752-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECCIA",
        "first_name": "JAKE",
        "middle_name": "ANTHONY",
        "credential": "RN, BSN, EMT-P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "768702",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "768702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Sampson Pease, MPT
• Jaclyn Brooke Pease, PSY.D.
• Stacie Pease
• Jamie Peatrowsky, PA-C
• Michelle Jeanette Peattie, AU.D.
• Robert Luke Pecha, MD
• Brian Richard Peck, DMD
• Caroline Anne Peck, M.D.
• Devin Sean Peck, LPCC TRAINEE
• Garrett Peck

• Psychiatric/Mental Health Registered Nurse in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.