Individual
JACQUELINE MARIE CALKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2625 FAIR OAKS BLVD, SACRAMENTO, CA 95864-4936
(916) 646-3376
(916) 646-3336
Mailing address
2625 FAIR OAKS BLVD, SUITE 1, SACRAMENTO, CA 95864-4936
(916) 646-3376
(916) 646-3336
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G081375
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G081375
STATE LICENSE
CA
05
—
GR0098940
—
CA
01
—
TAX ID NUMBER
432054849
CA
Enumeration date
03/09/2006
Last updated
03/08/2023
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