Individual
JACQUELINE L BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 LOCUST DR, VALLEJO, CA 94591-4343
(916) 708-8863
Mailing address
1001 LOCUST DR, VALLEJO, CA 94591-4343
(916) 708-8863
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D1309700
CA
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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