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JAXON MARCEL GRANDCHAMP SUDRC
NPI 1972383792
Counselor - Addiction (Substance Use Disorder) in Sacramento, CA

Active since September 29, 2023
2100 CAPITOL AVE, SACRAMENTO, CA 95816(916) 442-4985 Get Directions Write a Review

NPPES record last updated: September 29, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jaxon Marcel Grandchamp Sudrc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAXON MARCEL GRANDCHAMP SUDRC (NPI 1972383792) is an individual addiction (substance use disorder) provider in Sacramento, California, licensed in California (12856) and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1972383792
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJAXON MARCEL GRANDCHAMPCredential: SUDRC
Location Address2100 CAPITOL AVESacramento, CA 95816-5721
Mailing Address2100 Capitol AveSacramento, CA 95816-5721 · (916) 442-4985
Phone(916) 442-4985
Sole ProprietorNo
Enumeration DateSeptember 29, 2023
NPPES CertifiedSeptember 29, 2023
✔ NPI 1972383792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · 12856
2100 CAPITOL AVE, Sacramento, CA 95816
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CELIA GISO
Counselor (Addiction (Substance Use Disorder))
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
TONI LEANNE BOTTA
Counselor (Addiction (Substance Use Disorder))
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
LAURA MARIE JASTER
Counselor (Addiction (Substance Use Disorder))
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
WEDDELL ORNETTE WADDELL
Counselor (Addiction (Substance Use Disorder))
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
LORIE DESANTO
Counselor (Addiction (Substance Use Disorder))
2100 CAPITOL AVE, SUITE A
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
SUERTE VALDEZ CRISOSTOMO
Licensed Vocational Nurse
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
CHRISTINE RENE BELL MD
Preventive Medicine (Addiction Medicine)
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985
MR. MICHAEL A BROOKS JR.
Counselor (Addiction (Substance Use Disorder))
2100 CAPITOL AVE
SACRAMENTO, CA 95816
Sacramento County (916) 442-4985

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 Jaxon Grandchamp's NPI number?

The NPI number for Jaxon Grandchamp is 1972383792. It was assigned to this individual provider in the NPPES registry on September 29, 2023.

Where is Jaxon Grandchamp located?

Jaxon Grandchamp practices at 2100 Capitol Ave, Sacramento, CA 95816. The listed phone number is (916) 442-4985.

What is Jaxon Grandchamp's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jaxon Grandchamp was last updated on September 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.