JACQUELINE LICAUCO NP
NPI 1467857284
Nurse Practitioner - Family in Burbank, CA
About Jacqueline Licauco Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE LICAUCO NP (NPI 1467857284) is an individual family provider in Burbank, California, licensed in California (95000859) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Burbank, and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacqueline Licauco Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jacqueline Licauco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Santa Clarita, CA 91387
- Reassigned Medicare billing, California enrollment
- 684 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91505 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacqueline Licauco's NPI number?
The NPI number for Jacqueline Licauco is 1467857284. It was assigned to this individual provider in the NPPES registry on October 23, 2014.
Where is Jacqueline Licauco located?
Jacqueline Licauco practices at 191 S Buena Vista Suite 100, Burbank, CA 91505. The listed phone number is (818) 869-7600.
What is Jacqueline Licauco's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jacqueline Licauco enrolled in Medicare?
Yes. Jacqueline Licauco is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jacqueline Licauco's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Licauco reassigns Medicare benefits to Providence Facey Medical Foundation (Santa Clarita, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Licauco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacqueline Licauco accept?
Health plans from Blue Cross and Blue Shield of Texas list Jacqueline Licauco as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacqueline Licauco was last updated on June 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacqueline Licauco, NP · NPI 1467857284
Family physician in Burbank, California. Individual provider, active in the CMS NPPES registry since October 23, 2014.
## Identity
- **NPI:** 1467857284 (Entity type: Individual)
- **Enumerated:** October 23, 2014
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95000859 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 191 S BUENA VISTA, SUITE 100, Burbank, CA 91505-4554
- **Phone:** (818) 869-7600 · **Fax:** (814) 433-3691
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Providence Facey Medical Foundation (NPI 1922651561, Santa Clarita, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** June 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1467857284) · Data from the CMS NPPES public registry.