Active NPI
Jacklyn Jean Cupp
- Physician Assistant
- Claremont, CA
National Provider Identifier
1598577215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 101 Bucknell Ave Unit 345
Claremont, CA 91711-4944 - Phone
- (714) 310-2025
- NPI assigned
- Jan 21, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
101 Bucknell Ave Unit 345
Claremont, CA 91711-4944
Mailing address
9940 Talbert Ave # 101
Fountain Valley, CA 92708-5153
Phone (714) 545-8700
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1598577215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9940 TALBERT AVE # 101",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927085153",
"telephone_number": "714-545-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BUCKNELL AVE UNIT 345",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917114944",
"telephone_number": "714-310-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUPP",
"first_name": "JACKLYN",
"middle_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-21",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.