Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeffensen Jay Timacdog

Individual provider Nurse Practitioner · NPI 1083103956

Jeffensen Jay Timacdog is a Nurse Practitioner in San Diego, California. Graduated from University of South Alabama College of Medicine in 2017, 9 years ago. Practices with Dymphna San Diego TMS Inc, an 8-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
9
Trained at
University of South Alabama College of Medicine
Licensed in
CA
In the registry since
2018
Specialties on file
3
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Practice location Address checks out

6920 Miramar Rd Ste 326
San Diego, CA 92121-2642
Phone: (619) 345-0086
Fax: (619) 345-0086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9920 Pacific Heights Blvd Ste 150, San Diego, CA 92121-4361 — (818) 337-8701

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95008823 (CA)
Nurse Practitioner Taxonomy 363L00000X · Licence 95008823 (CA)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence NP95008823 (CA)

Record details

NPI number1083103956
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 7, 2018
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Dymphna San Diego Tms Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in San Diego