Provider Demographics
NPI:1912592098
Name:SCHOMBERG, JACQUELINE L
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:L
Last Name:SCHOMBERG
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 1:650 RECORD ST APT 418
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-3377
Mailing Address - Country:US
Mailing Address - Phone:208-293-7168
Mailing Address - Fax:
Practice Address - Street 1:650 RECORD ST APT 418
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3377
Practice Address - Country:US
Practice Address - Phone:208-293-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide