Jacob Michael Pedraza, BS

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

739 Raft LN
Oxnard, CA 93035-1225

Phone

(805) 201-0529

NPI assigned

Oct 18, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

Practice roles

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.

• New Way Group Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Oxnard, CA
  • NPI 1962127902
  NPD
• New Way Group Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Oxnard, CA
  • NPI 1093301848
  NPD (past)

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1841916103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 CORONADO PL",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303124",
            "telephone_number": "805-754-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 RAFT LN",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351225",
            "telephone_number": "805-201-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JPEDRAZA14",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Michael Pearson, DPM
• Alesy Aurora Pech
• Christina Barba Pech, PA-C
• Benjamin T Pecht, M.D.
• Nova Clove Pedraza-Ryor, NONE
• Pegasus Transit, Inc.
• Sarah Ann Pegler, M.S. CCC-SLP
• Kathleen Manalo Pelias, FNP-BC
• Joanna Pelino
• Pence Dental Corporation

• Rehabilitation Practitioner in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.