Sara Jefferson, PSYD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

94027945 Issued in CA

Practice address

3200 E Guasti Rd Ste 100
Ontario, CA 91761-8661

Phone

(909) 527-5969

NPI assigned

Oct 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1609648948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ORANGEGROVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E GUASTI RD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618661",
            "telephone_number": "909-527-5969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23046 Avenida De La Carlota Ste 600",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926531537",
            "country_code": "US",
            "telephone_number": "949-229-5953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SARA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "94027945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JDCM Corporation
• JDMD Clinics, Apc
• Jebcob
• Jordan Jedlick
• Jazmyn Jefferson
• Youngsen Jeng, DPM
• Jenkins Family Nursing Medical Practice, Inc
• Charlotte Ann Jenkins, FNP-BC
• Teana Jenkins
• Clarissa Danae Jennings

• Student in an Organized Health Care Education/Training Program in Ontario, CA
• Providers in Ontario, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.