Jennica Alyse Hagan, DNP, APRN, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

95023812 Issued in CA

Practice address

4301 X St
Sacramento, CA 95817-2214

Phone

(916) 734-2011

NPI assigned

Jan 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the Univ of Ca

  • Trauma Surgery Physician
  • Sacramento, CA
  • NPI 1568455590
  NPD
• Regents of the Univ of Ca

  • Pulmonary Disease Physician
  • Sacramento, CA
  • NPI 1437142692
  NPD (past)

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1992419626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 DATA DR APT 1428",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706449",
            "telephone_number": "636-352-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "916-734-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "JENNICA",
        "middle_name": "ALYSE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CA",
            "license": "95023812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quency C Hadisubroto
• Peyton Elisabth Hadley
• Danielle Renee Haener, PSY.D.
• Katie A Haertle, RN
• Hanns C Haesslein, M.D.
• Sharon Muns Hagan, PSYD
• Madeline Hagarty
• Lillian E. Hage-Fischer, MD
• Alec Hageman
• Katy Hagen

• Neonatal Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Neonatal Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.