MEDICARE: JAYDON CHRISTIAN JEFFERSON-SAENZ I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion		CA
2	175T00000X	Peer Specialist	Y8470003	CA
3	372600000X	Adult Companion

General Provider Information

NPI Number	:	1851109235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYDON CHRISTIAN JEFFERSON-SAENZ I

Provider Business Mailing Address
First Line	:	811 GRAND AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95838-3466
Country	:	US
Telephone Number	:	916-922-9868
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 GRAND AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95838-3466
Country	:	US
Telephone Number	:	916-922-9868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	01/05/2026

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Directions to “ JAYDON CHRISTIAN JEFFERSON-SAENZ I ” Practice Location

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