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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013919349 | NPPES |
| California | Other | 54220ZZZ07464Z | BLUE SHIELD PIN |
| California | Other | P00066377 | BLUE SHIELD PIN |
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