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NPI Code Detail

MEDICARE: JACELIN CLAYTON

MEDICARE: JACELIN CLAYTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1568296333
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACELIN CLAYTON
Provider Business Mailing Address
First Line : 1202 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3842
Country : US
Telephone Number : 801-636-1280
Fax Number :
Provider Business Practice Location Address
First Line : 1202 MORENA BLVD STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3842
Country : US
Telephone Number : 619-275-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2024
Last Update Date : 04/08/2026

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Directions to “ JACELIN CLAYTON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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