Individual provider Active NPI

Jessica Theresa Greisen

  • Physician Assistant
  • Folsom, CA
National Provider Identifier
1972188910
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63869 Issued in CA
Practice address
2220 E Bidwell St
Folsom, CA 95630-3463
Phone
(916) 800-4685
NPI assigned
Mar 11, 2021
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 63869 CA Primary

Addresses

Primary practice location

2220 E Bidwell St
Folsom, CA 95630-3463

Mailing address

2220 E Bidwell St
Folsom, CA 95630-3463
Phone (916) 800-4685

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206001079 CA Practitioner - Physician Assistant 7113360207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis Loidolt DO IncGroup PAC ID 4587991674, 4 clinicians

Practice addresses (Care Compare)

2220 E Bidwell St
Folsom, CA 95630-3463
Phone (916) 800-4685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
63869CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Dec 24, 2023 Accepting new patients
Cep America-California CurrentSince Dec 24, 2023 Accepting new patients
Cep America - California CurrentSince Dec 24, 2023 Accepting new patients
Travis Loidolt D.O. Inc Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1972188910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 E BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-800-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 E BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-800-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREISEN",
        "first_name": "JESSICA",
        "middle_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.