Active NPI
Jirina Zahradnickova I, PSY.D
- Psychologist
- Represa, CA
National Provider Identifier
1679705024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 22911
- Practice address
- 100 Prison Rd
Represa, CA 95671-3000 - Phone
- (916) 985-8610
- NPI assigned
- Aug 19, 2009
- Last updated
- Aug 19, 2009
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 22911 | CA | Primary |
Addresses
Primary practice location
100 Prison Rd
Represa, CA 95671-3000
Mailing address
PO Box 290002
Represa, CA 95671-0002
Phone (916) 985-8610
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22911 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba California State Prison-Sacramento
- Pharmacy
- Represa, CA
- NPI 1154953529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1679705024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 290002",
"city": "REPRESA",
"state": "CA",
"postal_code": "956710002",
"telephone_number": "916-985-8610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PRISON RD",
"city": "REPRESA",
"state": "CA",
"postal_code": "956713000",
"telephone_number": "916-985-8610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAHRADNICKOVA",
"first_name": "JIRINA",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-19",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "22911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Represa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.