Jesse J. Jacquez, P.A.-C.
Physician Assistant, Medical in Colton, CA. Individual provider (NPI-1).
NPI number1285644294
StatusActive
Last updated in NPPESJun 15, 2023
Details
- NPI
- 1285644294
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jesse J. Jacquez
- Credential
- P.A.-C.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 9, 2006
- Certification date
- Jun 15, 2023
- Last updated
- Jun 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA10031 | CA | Yes |
Practice location
895 W Valley BlvdColton, CA 92324-2001
Phone 909-824-3389 · Fax 909-824-1087
Mailing address
895 W Valley BlvdColton, CA 92324-2001
Phone 909-824-3389 · Fax 909-824-1087
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