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Individual

DR. JACQUELINE ELIZABETH SERENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
34800 BOB WILSON DR, NMCSD, ATTN: MEDICAL STAFF SERVICES, SAN DIEGO, CA 92134-1098
(619) 532-6460
(619) 532-6299
Mailing address
34520 BOB WILSON DR STE 100, SAN DIEGO, CA 92134-2100
(619) 532-6896
(619) 532-9184

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G76179
CA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G76179
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20431
MEDI-CAL
CA
Enumeration date
01/27/2006
Last updated
03/27/2026
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