Active NPI
Stephanie Jacobs, BCBA
- Behavior Analyst
- Sacramento, CA
National Provider Identifier
1942557699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1119379
- Practice address
- 9755 Lincoln Village Dr
Sacramento, CA 95827-3334 - Phone
- (916) 363-6103
- Fax
- (916) 363-6294
- NPI assigned
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1119379 | CA | Primary |
Addresses
Primary practice location
9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Mailing address
9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone (916) 363-6103
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1119379 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1942557699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9755 LINCOLN VILLAGE DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958273334",
"telephone_number": "916-363-6103",
"fax_number": "916-363-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9755 LINCOLN VILLAGE DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958273334",
"telephone_number": "916-363-6103",
"fax_number": "916-363-6294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "STEPHANIE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-13",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1119379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.