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Individual

JACQUELINE MARGOLESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, FNP-C, AG-ACNP

Contact information

Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5305
(510) 727-2759
Mailing address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5305
(510) 727-2759

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95008327
CA
363LF0000X
Family Nurse Practitioner
APRN-2206
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
N/A
Enumeration date
11/15/2016
Last updated
10/23/2018
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