Individual
JACKQUELYN PAIGE VIRGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1530 3RD ST STE 106, LINCOLN, CA 95648-2500
(530) 440-1162
Mailing address
1530 3RD ST STE 106, LINCOLN, CA 95648-2500
(916) 434-8927
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-UMDLBZ
CA
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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