Individual
JAQUELINE BILLIE JEPSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
384 JACKSON ST STE 4B, HAYWARD, CA 94544-1556
(510) 500-6769
Mailing address
384 JACKSON ST STE 4B, HAYWARD, CA 94544-1556
(510) 500-6769
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9716
CA
Other
Enumeration date
12/10/2021
Last updated
01/09/2023
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