Jada Marie Krueger

Individual provider Active NPI Licensed Vocational Nurse · Pollock Pines, CA

NPI 1679422281 · NPPES record last updated Jan 26, 2026

Key facts

NPI
1679422281
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
235805 (CA)
Practice address
5031 Shooting Star Rd
Pollock Pines, CA 95726-9447
Phone
(760) 666-0869
NPI assigned
Jan 26, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
235805CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 235805 CA Yes

Addresses

Primary practice location

5031 Shooting Star Rd
Pollock Pines, CA 95726-9447

Mailing address

5031 Shooting Star Rd
Pollock Pines, CA 95726-9447
Phone (760) 666-0869

Other providers in Pollock Pines, CA

All providers in Pollock Pines, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.