Jackie Lou Tabbada

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

347000518 Issued in CA

Practice address

4801 34TH St
Sacramento, CA 95820-4849

Phone

(916) 364-8395

NPI assigned

Oct 29, 2014

Sex

Female

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

• Ronalyn Taaca Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1851796130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 SELVA WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957578210",
            "telephone_number": "916-601-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 34TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958204849",
            "telephone_number": "916-364-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABBADA",
        "first_name": "JACKIE LOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "347000518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALYN",
            "last_name": "TAACA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Adrian Tabares, M.D.
• Connie Tabarez
• Jesse E. Tabarez, MSW
• Sanaz Tabatabaei, MD
• Ayran Tabayoyong
• Tarah Taber
• Diosdado L Tabilon, M.D.
• Jeffrey Casimiro Tabinas, DPT
• Stacey Tablit
• Angel D Tabuyo-Martin, MD

• Mental Illness Community Based Residential Treatment Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.