Individual provider Active NPI

Judy Jolley, RN

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1780041616
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
171927 Issued in CA
Practice address
9719 Lincoln Village Dr Ste 105
Sacramento, CA 95827-3328
Phone
(916) 362-8292
Fax
(916) 362-8295
NPI assigned
Jan 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 171927 CA Primary

Addresses

Primary practice location

9719 Lincoln Village Dr Ste 105
Sacramento, CA 95827-3328

Mailing address

9719 Lincoln Village Dr Ste 105
Sacramento, CA 95827-3328
Phone (916) 362-8292

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
171927CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1780041616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 LINCOLN VILLAGE DR STE 105",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273328",
            "telephone_number": "916-362-8292",
            "fax_number": "916-362-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9719 LINCOLN VILLAGE DR STE 105",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273328",
            "telephone_number": "916-362-8292",
            "fax_number": "916-362-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "JUDY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "171927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.