Individual
DR. JENNY MARIELLA JAQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 N STATE ST, LOS ANGELES, CA 90033-1029
(323) 226-2622
Mailing address
657 ORANGE GROVE AVE APT C, S PASADENA, CA 91030-2332
(909) 709-4906
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
A96288
CA
Other
Enumeration date
02/11/2008
Last updated
11/01/2021
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