Individual provider · Type 1 NPI

Jacquelyn Banouvong

Specialist · Daly City, CA

NPI number 1851036073 Active

Practice location

3 Morton Dr
Daly City, CA 94015-4415

Call (415) 407-0561 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1851036073

Jacquelyn Banouvong's National Provider Identifier is 1851036073, issued on May 2, 2022. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Daly City, CA. The record was last updated on May 2, 2022.