Campos, Jacqueline

Campos, Jacqueline is an individual health care provider with primary practice located at 21229 Hawthorne Blvd Ste A , Torrance CA 90503-5501. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Campos, Jacqueline can be contacted via phone (310) 792-5600.

Contact Information

Primary practice address
21229 Hawthorne Blvd Ste A Torrance CA 90503-5501
Phone: (310) 792-5600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X 96737 California

Profile Details

NPI number 1538731195
LBN Legal business name Campos, Jacqueline
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2021
Last updated Jul 13th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538731195 NPPES
California MEDICAID 96737

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