Healthcare Provider Details

I. General information

NPI: 1538695366
Provider Name (Legal Business Name): JAMIE SHEETS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 NW CLEARWATER DR STE 100
BEND OR
97703-9412
US

IV. Provider business mailing address

680 E COLORADO BLVD STE 180
PASADENA CA
91101-6144
US

V. Phone/Fax

Practice location:
  • Phone: 913-660-5266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW124740
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberACSW124740
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number43911
License Number StateID
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL18354
License Number StateOR
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: