Provider Demographics
NPI:1407608078
Name:LOERA, JACQUELINE ASHLEY
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ASHLEY
Last Name:LOERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 AUBURN WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3102
Mailing Address - Country:US
Mailing Address - Phone:559-772-5711
Mailing Address - Fax:
Practice Address - Street 1:1455 AUBURN WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3102
Practice Address - Country:US
Practice Address - Phone:559-772-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula