Provider Demographics
NPI:1568035988
Name:TOZAKI, JACLYN FELICIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:FELICIA
Last Name:TOZAKI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 WISCONSIN AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4301
Mailing Address - Country:US
Mailing Address - Phone:855-729-2272
Mailing Address - Fax:202-833-1725
Practice Address - Street 1:5530 WISCONSIN AVE STE 1200
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4301
Practice Address - Country:US
Practice Address - Phone:855-729-2272
Practice Address - Fax:202-833-1725
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR188320363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health