Idun, Jacqueline

Idun, Jacqueline is an individual health care provider with primary practice located at 2213 Buchanan Rd Ste 103 , Antioch CA 94509-4265. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Idun, Jacqueline can be contacted via phone (925) 303-4780.

Contact Information

Primary practice address
2213 Buchanan Rd Ste 103 Antioch CA 94509-4265
Phone: (925) 303-4780
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 95071879 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95014031 California

Profile Details

NPI number 1659903045
LBN Legal business name Idun, Jacqueline
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 4th, 2020
Last updated Apr 6th, 2020 - about 5 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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