Gregory Alan Jaeck

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G42115 Issued in CA

Practice address

7700 Folsom Blvd.
Sacramento, CA 95825

Phone

(916) 386-3000

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Gregory Alan Jaeck Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831298165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "SHINGLE SPRINGS",
            "state": "CA",
            "postal_code": "956820002",
            "telephone_number": "530-677-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FOLSOM BLVD.",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95825",
            "telephone_number": "916-386-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECK",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G42115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "JAECK",
            "middle_name": "ALAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.