Katie Ellen Jacquez

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

601 5TH Ave
Upland, CA 91786-4839

Phone

(909) 949-6526

NPI assigned

Aug 26, 2025

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

Practice roles

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

• Upland Unified School District

  • Community/Behavioral Health Agency
  • Upland, CA
  • NPI 1093180515
  NPD (past)

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1700764867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12791 REED AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923136029",
            "telephone_number": "909-648-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864839",
            "telephone_number": "909-949-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUEZ",
        "first_name": "KATIE",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taufik Farady Iskaq, D.D.S.
• Ivy Hospice Care, Inc.
• Diba Izadyar, PA-C
• Thomas Jacobs
• Tami Janine Jacobson, NP
• Catherine Dinglasan Jaeger, LMFT (LICENSED MARRI
• Daksha Ashok Jain, MD
• Jameco Home Health Agency, Inc.
• James C Ho M.D. Medical Corporation
• James R Larose DPM a Professional Corp

• All providers in Upland, CA
• Health & Wellness Coach in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.