Individual provider Active NPI

Jennifer Anne Hetzner, M.D.

  • Emergency Medicine Physician
  • Sacramento, CA
National Provider Identifier
1831401447
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A125035 Issued in CA
Practice address
2801 L St
Sacramento, CA 95816-5615
Phone
(916) 454-2222
NPI assigned
Jul 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X A125035 CA
Emergency Medicine Physician 207P00000X A125035 CA Primary

Addresses

Primary practice location

2801 L St
Sacramento, CA 95816-5615

Mailing address

PO Box 68
Lodi, CA 95241-0068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130805000383 CA Practitioner - Emergency Medicine 1153563101 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Oroville Hospital CurrentSince Nov 7, 2020 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 1, 2013 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Apr 15, 2015 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Aug 1, 2013 Accepting new patients
Oroville Hospital CurrentSince Nov 7, 2020 Accepting new patients

Locations

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2801 L St
Sacramento, CA 95816
Phone (916) 454-2222

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

1325 Cottonwood St
Woodland, CA 95695
Phone (530) 662-3961

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1831401447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952410068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 L ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165615",
            "telephone_number": "916-454-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZNER",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A125035",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A125035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.