Green, Jacquelyn Kay

Green, Jacquelyn Kay is an individual health care provider with primary practice located at 12450 Van Nuys Blvd , Pacoima CA 91331-1391. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Green, Jacquelyn Kay can be contacted via phone (818) 896-8366.

Contact Information

Primary practice address
12450 Van Nuys Blvd Pacoima CA 91331-1391
Phone: (818) 896-8366
Fax: (818) 896-8392
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A23900 California

Profile Details

NPI number 1447381512
LBN Legal business name Green, Jacquelyn Kay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2007
Last updated Jul 8th, 2007 - about 17 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 1447381512 NPPES
California Other 00HH334 EMPLOYEE I D NUMBER

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