Individual provider Active NPI

Jacqueline Ann Johal-Morales

  • Family Medicine Physician
  • Pittsburg, CA
National Provider Identifier
1609358373
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A183301 Issued in CA
Practice address
2311 Loveridge Rd
Pittsburg, CA 94565-5117
Phone
(800) 495-8885
NPI assigned
Aug 30, 2018
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A183301 CA Primary

Addresses

Primary practice location

2311 Loveridge Rd
Pittsburg, CA 94565-5117

Mailing address

2311 Loveridge Rd
Pittsburg, CA 94565-5117
Phone (800) 495-8885

Other practice location 1

4610 X St
Sacramento, CA 95817-2200
Phone (916) 816-1603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241210001528 CA Practitioner - Family Practice 6901332261 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A183301CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County Current Accepting new patients
Contra Costa County CurrentSince Dec 2, 2024 Accepting new patients
Contra Costa County CurrentSince Dec 2, 2024 Accepting new patients

Locations

2311 Loveridge Rd
Pittsburg, CA 94565
Phone (800) 495-8885

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1609358373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 LOVERIDGE RD",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655117",
            "telephone_number": "800-495-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 LOVERIDGE RD",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945655117",
            "telephone_number": "800-495-8885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 X St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172200",
            "country_code": "US",
            "telephone_number": "916-816-1603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHAL-MORALES",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A183301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, CA

Sources for this page

Verify at the official NPI Registry.