Randa, Jacqueline

Randa, Jacqueline is an individual health care provider with primary practice located at 874 American Pacific Dr , Henderson NV 89014-8800. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as her primary health care specialty. Randa, Jacqueline can be contacted via phone (702) 777-3122.

Contact Information

Primary practice address
874 American Pacific Dr Henderson NV 89014-8800
Phone: (702) 777-3122
Fax: (702) 777-3055
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT28176 California
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 2845 Nevada

Profile Details

NPI number 1013919349
LBN Legal business name Randa, Jacqueline
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Jul 23rd, 2013 - about 12 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 1013919349 NPPES
California Other 54220ZZZ07464Z BLUE SHIELD PIN
California Other P00066377 BLUE SHIELD PIN

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