Individual
JACQUELINE MARIE PORTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1000
Mailing address
841 MAYO CT, BENICIA, CA 94510-3803
(707) 980-1326
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
31868
CA
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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