Individual
JASON PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C, D.C.
Contact information
Practice address
151 N SUNRISE AVE, SUITE 1005, ROSEVILLE, CA 95661-2924
(916) 782-1217
(916) 782-7630
Mailing address
151 N SUNRISE AVE, SUITE 1005, ROSEVILLE, CA 95661-2924
(916) 782-1217
(916) 782-7630
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC29082
CA
363AS0400X
Surgical Physician Assistant
Primary
23146
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0290820
BLUE SHIELD IDENTIF. NUMB
CA
Enumeration date
09/02/2006
Last updated
03/05/2014
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