Individual provider Active NPI

Jacqulyne Helene Sylvia Wynne

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1861844367
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19051 Issued in CA
Practice address
965 El Camino Ave
Sacramento, CA 95815-2530
Phone
(916) 642-1867
NPI assigned
Jul 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 19051 CA
Family Medicine Physician 207Q00000X 19051 CA Primary

Addresses

Primary practice location

965 El Camino Ave
Sacramento, CA 95815-2530

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other practice location 1

1020 29th St
Sacramento, CA 95816-4891
Phone (800) 866-7724

Other names 1

  • Jacqulyne Helene Sylvia Professional name

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
I20210907002659 CA Practitioner - Family Practice 9931505518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chapa-de Indian Health Program, Inc.Group PAC ID 4981688520, shared by 2 NPIs, 54 clinicians

Practice addresses (Care Compare)

11670 Atwood Rd
Auburn, CA 95603-9522
Phone (530) 887-2800

Hospital & facility affiliations

  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19051CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Oct 7, 2024 Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Clinica de Salud del Valle de Salinas CurrentSince Nov 1, 2024 Accepting new patients
Clinica de Salud del Valle de Salinas Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2725 Capitol Ave
Dept 304
Sacramento, CA 95816
Phone (916) 262-9414

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

55 Plaza Cir
Ste A
Salinas, CA 93901
Phone (831) 757-0434

440 Airport Blvd
Salinas, CA 93905
Phone (831) 757-0434

Interoperability endpoints

  • Direct secure messaging: jsylvia650062@hisp.ehr.sutterhealth.org
  • Direct secure messaging: jacqulyne.sylvia@cdih.eclinicaldirectplus.com
  • Direct secure messaging: jacqulyne.sylvia.p1@direct.csvs.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1861844367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 EL CAMINO AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958152530",
            "telephone_number": "916-642-1867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 29th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958164891",
            "country_code": "US",
            "telephone_number": "800-866-7724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYLVIA WYNNE",
        "first_name": "JACQULYNE",
        "middle_name": "HELENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "19051",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "19051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQULYNE",
            "last_name": "SYLVIA",
            "middle_name": "HELENE",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.