Healthcare Provider Details

I. General information

NPI: 1407785769
Provider Name (Legal Business Name): JACQUELINE ELISE LIMM PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 FRANCISCO DR STE 220-585
EL DORADO HILLS CA
95762-3762
US

IV. Provider business mailing address

2222 FRANCISCO DR STE 220-585
EL DORADO HILLS CA
95762-3762
US

V. Phone/Fax

Practice location:
  • Phone: 916-365-2184
  • Fax:
Mailing address:
  • Phone: 916-365-2184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA68410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: