Provider Demographics
NPI:1184084477
Name:BORGES, JACQUELINE
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:BORGES
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 1:10350 THOMAS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-5449
Mailing Address - Country:US
Mailing Address - Phone:775-853-5508
Mailing Address - Fax:775-828-9832
Practice Address - Street 1:10350 THOMAS CREEK RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-5449
Practice Address - Country:US
Practice Address - Phone:775-853-5508
Practice Address - Fax:775-828-9832
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005054653Medicaid