Provider Demographics
NPI:1548583578
Name:TURNER, JACQUELINE MARIE
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:MARIE
Last Name:TURNER
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 1:3960 ADELINE ST
Mailing Address - Street 2:308
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3783
Mailing Address - Country:US
Mailing Address - Phone:415-571-9269
Mailing Address - Fax:415-931-8167
Practice Address - Street 1:3960 ADELINE ST
Practice Address - Street 2:308
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-3783
Practice Address - Country:US
Practice Address - Phone:415-571-9269
Practice Address - Fax:415-931-8167
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV415-571-9269 CALL ME225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist