Provider Demographics
NPI:1194461608
Name:SAKAI, JACQUELINE (CAMTC)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:
Last Name:SAKAI
Suffix:
Gender:F
Credentials:CAMTC
Other - Prefix:MS
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:SAKAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JACQUELINE SAKAI LMT
Mailing Address - Street 1:1891 E ROSEVILLE PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7975
Mailing Address - Country:US
Mailing Address - Phone:916-936-1854
Mailing Address - Fax:
Practice Address - Street 1:1891 E ROSEVILLE PKWY STE 170
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7975
Practice Address - Country:US
Practice Address - Phone:916-936-1854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-08
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69592225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty