Breanna Lyn Jaco

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT134845 Issued in CA

Practice address

2750 Sutterville Rd
Sacramento, CA 95820-1093

Phone

(916) 452-3981

NPI assigned

Feb 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1790286094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 SUTTERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 SUTTERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201093",
            "telephone_number": "916-452-3981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2366 Maritime Dr",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957583639",
            "country_code": "US",
            "telephone_number": "916-365-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACO",
        "first_name": "BREANNA",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT134845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toneyamalayshia D Jackson
• Tracey L Jackson
• Victoria Lynn Jackson, DNP, FNP-C, PA-C
• Wanda Lavina Jackson
• Jackson's Facilities, Incorporated
• Penny Jean Jaco, MFTI
• Richard Jaco
• Dan Lemuel Directo Jacob
• Gabriel Jacob, M.D.
• Maricel Jacob

• Marriage & Family Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.