Individual provider Active NPI

Jessica Ann Owens, RT

  • Radiography Radiologic Technologist
  • Soquel, CA
National Provider Identifier
1912460569
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
565132 Issued in CA
Practice address
3601 Caldwell Dr
Soquel, CA 95073-2055
Phone
(831) 576-3000
Fax
(831) 713-5398
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 565132 CA
Radiography Radiologic Technologist 2471C3402X 565132 CA Primary

Addresses

Primary practice location

3601 Caldwell Dr
Soquel, CA 95073-2055

Mailing address

3601 Caldwell Dr
Soquel, CA 95073-2055
Phone (831) 576-3000

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

State licenses

LicenseStateTypeSpecialty
565132CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Agile Occupational Medicine, PC PastSince Oct 9, 2022 Accepting new patients
Emeryville Occupational Medical Center Past Accepting new patients

Organizations & group practices 2

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1912460569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 CALDWELL DR",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732055",
            "telephone_number": "831-576-3000",
            "fax_number": "831-713-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 CALDWELL DR",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732055",
            "telephone_number": "831-576-3000",
            "fax_number": "831-713-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "RT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "565132",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "565132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soquel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.