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Individual
JACQUELINE ANN VINCENT
Active
Individual
JACQUELINE ANN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
296395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296395
PHYSICAL THERAPY LICENSE
CA
Enumeration date
02/25/2019
Last updated
02/25/2019
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