Individual provider Active NPI

Jacqueline Hutchison

  • Sports Medicine (Family Medicine) Physician
  • Campbell, CA
National Provider Identifier
1841078110
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
PA66415 Issued in CA
Practice address
221 E Hacienda Ave Ste B
Campbell, CA 95008-6625
Phone
(408) 376-3350
Fax
(408) 374-4130
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X PA66415 CA Primary

Addresses

Primary practice location

221 E Hacienda Ave Ste B
Campbell, CA 95008-6625

Mailing address

221 E Hacienda Ave Ste B
Campbell, CA 95008-6625
Phone (408) 376-3350

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC Past Accepting new patients

Organizations & group practices 1

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1841078110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE STE B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086625",
            "telephone_number": "408-376-3350",
            "fax_number": "408-374-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE STE B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086625",
            "telephone_number": "408-376-3350",
            "fax_number": "408-374-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "PA66415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.