Stephanie Jacks
Stephanie Jacks is a Pediatrics Physician in Roseville, CA, registered under NPI 1003041567. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
Here is what surrounds this office in Roseville, based on OpenStreetMap data collected Sep 1, 2026. Parking is available about 0.49 mi away at Maidu Park Park And Ride. There is EV charging 0.26 mi from the office (Tesla Supercharger) — useful if you are driving in from out of town. The nearest transit stop is 964 ft away, served by Rocky Ridge before Hackamore. If you arrive early, there is a coffee shop 0.37 mi away.
Getting here and what is nearby
Restaurant Jamba 261 ft ~1 min
2030 Douglas Boulevard, Roseville 95661
Mo-Fr 07:00-20:00; Sa-Su 08:00-20:00
Coffee Teaspoon 308 ft ~2 min
2030 Douglas Boulevard
Restaurant Noah's Bagels 333 ft ~2 min
Coffee Starbucks 371 ft ~2 min
Grocery Sprouts Farmers Market 418 ft ~2 min
2030 Douglas Boulevard, Roseville 95661
07:00-22:00
Parking 449 ft ~2 min
Restaurant Romano's Macaroni Grill 610 ft ~3 min
2010 Douglas Boulevard
Transit Douglas at Rocky Ridge 792 ft ~4 min
Transit Rocky Ridge at Hackamore 911 ft ~4 min
Parking 905 ft ~4 min
Transit Rocky Ridge before Hackamore 964 ft ~4 min
EV charging Tesla Supercharger 0.26 mi ~6 min
Coffee Lazi Cow 0.37 mi ~8 min
1850 Douglas Boulevard, Roseville 95661
Grocery Walmart Supercenter 0.48 mi ~10 min
1400 Lead Hill Boulevard, Roseville 95661
Mo-Su 06:00-24:00
Parking Maidu Park Park And Ride 0.49 mi ~10 min
Maidu Drive@Rocky Ridge Drive, Roseville 95661
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| R4401 | TX | Pediatrics Physician primary |
| R4401 | TX | Dermatology Physician |
This provider holds licence R4401 issued in TX. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Dermatology
- PAC ID
- 2466692967
- Enrollment ID
- I20220808001197
Medicare enrolment is recorded as approved under the provider type Practitioner - Dermatology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Pediatrics covers
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. NUCC Health Care Provider Taxonomy, code 208000000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 208000000X | Pediatrics Physician | R4401 | TX | primary |
| 207N00000X | Dermatology Physician | R4401 | TX |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1003041567 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 27, 2009 |
| Last updated | Jul 8, 2026 |
| Status | Active |
| Sole proprietor | No |
| Gender | Female |
| Practice address |
2120 PROFESSIONAL DR Roseville, CA 95661 (916) 771-7700 |
| Other identifiers |
06536832
· Medicaid (MS) P01500386 · Other (MS) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 0 | 4 | 1 | 5 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 0 | 4 | 2 | 5 | 3 |
Sum = 43 · next multiple of 10 = 50 · check digit = 7 · actual last digit = 7
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.