Individual
SCHAKE JACKIE MATJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
544 N GLENDALE AVE, GLENDALE, CA 91206-3311
(818) 241-4331
(818) 241-2253
Mailing address
544 N GLENDALE AVE, GLENDALE, CA 91206-3311
(818) 241-4331
(818) 241-2253
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19454
CA
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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