Jacqueline Elizabeth Pelletier, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

15739 Issued in CA

Practice address

3020 Childrens Way
San Diego, CA 92123-4223

Phone

(858) 966-1700

NPI assigned

Apr 23, 2009

Last updated

Apr 23, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240444800000",
    "number": "1568606309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5348 COLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171119",
            "telephone_number": "619-723-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JACQUELINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2009-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "15739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William E Pelham III, PHD
• Michelle Terez Pelle, M.D.
• Kristyn Gray Pellecchia, N.P.
• William J. Pellegrini II, LPCC
• Avery Gail Pellegrino
• Pierre Alfred Pelletier, MD
• Jessica Pellett
• Donald J. Pellioni, MD
• Julie Anne Pellman, RN
• Alexandra Mari Nazam Pelonia, PSY.D.

• Pediatric Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.