Jackqueline Medina

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

160 Glen Cove Marina Rd E Ste 102
Vallejo, CA 94591-7290

Phone

(707) 648-2000

NPI assigned

Aug 15, 2023

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

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1780467589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917290",
            "telephone_number": "707-648-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 GLEN COVE MARINA RD E STE 102",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917290",
            "telephone_number": "707-648-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JACKQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Lee Medcalf
• Medi-Core Transport, Inc
• Medic Ambulance Service Inc
• Medical Clinic for Noninvasive Vascular Studies of Solano County
• Medical Office of Concepcion and Lim
• Katherine Leones Medina, PHARM.D
• Ladonna Medina, BCEP
• Miriam Medina
• Medmark Treatment Services, Inc.
• Medmek Medical Clinic, Inc.

• Case Manager/Care Coordinator in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.