Individual
MRS. JEANNINE A. O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6555 COYLE AVE, SUITE 235, CARMICHAEL, CA 95608-0302
(916) 200-0087
Mailing address
2001 RATTLESNAKE RD, SUITE 235, NEWCASTLE, CA 95658-9722
(916) 663-2100
(916) 663-2103
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA14186
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00185911
RAILROAD MEDICARE
CA
Enumeration date
08/18/2006
Last updated
05/09/2016
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