Individual
MRS. JACQUELINE ELIZABETH PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-1700
Mailing address
5348 COLE ST, SAN DIEGO, CA 92117-1119
(619) 723-1141
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
15739
CA
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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