Jennifer Yvonne Treadwell, APRN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95015720 Issued in CA

Practice address

1625 Stockton Blvd Ste 112
Sacramento, CA 95816-7098

Phone

(916) 887-4877

Fax

(916) 887-4835

NPI assigned

Apr 24, 2013

Last updated

Jan 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtreadwell564623@hisp.ehr.sutterhealth.org

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

• Capital Allergy and Respiratory Disease Center a Med Corp

  • Allergy Physician
  • Sacramento, CA
  • NPI 1629191267
  Medicare reassignment NPD

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1831533553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STOCKTON BLVD STE 112",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167098",
            "telephone_number": "916-887-4877",
            "fax_number": "916-887-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STOCKTON BLVD STE 112",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167098",
            "telephone_number": "916-887-4877",
            "fax_number": "916-887-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "JENNIFER",
        "middle_name": "YVONNE",
        "credential": "APRN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP06244",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95015720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PTAN",
            "identifier": "292348YH54",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2336037",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Travis
• Tina Klatt Rosolack Traxler, PH.D.
• Jasmine Jeanette Traylor
• Lestine Traylor
• Shalyn Traylor
• Kayla Treanor, DNP
• Treasure Behavioral Health LLC
• Treat Mental Health California LLC
• Treatment Associates Inc
• Treatment Associates, Inc

• Pediatric Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.