Individual
JAQUELYN LORENZO MACARAEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 S ATLANTIC BLVD, SUITE 305, MONTEREY PARK, CA 91754-4730
(310) 550-6886
Mailing address
2080 CENTURY PARK E, SUITE 501, LOS ANGELES, CA 90067-2001
(310) 550-6886
(310) 550-6875
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
22205
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
22205
CA
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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