Serena, Jacqueline Elizabeth

Serena, Jacqueline Elizabeth is an individual health care provider with primary practice located at 34800 Bob Wilson Dr Nmcsd, Attn: Medical Staff Services, San Diego CA 92134-1098. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is her primary health care specialty. Serena, Jacqueline Elizabeth can be contacted via phone (619) 532-6460.

Contact Information

Primary practice address
34800 Bob Wilson Dr Nmcsd, Attn: Medical Staff Services San Diego CA 92134-1098
Phone: (619) 532-6460
Fax: (619) 532-6299
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G76179 California
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X G76179 California

Profile Details

NPI number 1346211497
LBN Legal business name Serena, Jacqueline Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Dec 14th, 2021 - about 3 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 1346211497 NPPES
California Other 20431 MEDI-CAL

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