Provider Demographics
NPI:1942444963
Name:BILLER, JACQUELINE RUTH (MPT)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:RUTH
Last Name:BILLER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:523 15TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-1623
Mailing Address - Country:US
Mailing Address - Phone:916-832-1958
Mailing Address - Fax:
Practice Address - Street 1:1200 SUNCAST LN
Practice Address - Street 2:SUITE 5
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9664
Practice Address - Country:US
Practice Address - Phone:916-934-0914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist