Active NPI
Jaclyn Czaja, MD
- Pediatrics Physician
- East Palo Alto, CA
National Provider Identifier
1689865719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A118008
- Practice address
- 1798 Bay Rd Ste a
East Palo Alto, CA 94303-5312 - Phone
- (650) 330-7400
- Fax
- (650) 321-1156
- NPI assigned
- Aug 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ML20008875 | WA | |
| Pediatrics Physician | 208000000X | MD60147874 | WA | |
| Pediatrics Physician | 208000000X | A118008 | CA | Primary |
Addresses
Primary practice location
1798 Bay Rd Ste a
East Palo Alto, CA 94303-5312
Mailing address
1798 Bay Rd Ste a
East Palo Alto, CA 94303-5312
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A118008 | CA | MD | Pediatrics Physician |
| MD60147874 | WA | MD | Pediatrics Physician |
| ML20008875 | WA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336608000000",
"number": "1689865719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1798 BAY RD STE A",
"city": "EAST PALO ALTO",
"state": "CA",
"postal_code": "943035312",
"fax_number": "650-321-1156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1798 BAY RD STE A",
"city": "EAST PALO ALTO",
"state": "CA",
"postal_code": "943035312",
"telephone_number": "650-330-7400",
"fax_number": "650-321-1156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZAJA",
"first_name": "JACLYN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2012-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "ML20008875",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD60147874",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A118008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.