| NPI | 1235553173 |
|---|---|
| Former Name | JACQUELYN VELASQUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015293) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2023-05-08 |