Healthcare Provider Details

I. General information

NPI: 1346980745
Provider Name (Legal Business Name): JACQUELINE BONITA BOOKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 WATT AVE
SACRAMENTO CA
95821-3600
US

IV. Provider business mailing address

3315 WATT AVE
SACRAMENTO CA
95821-3600
US

V. Phone/Fax

Practice location:
  • Phone: 916-481-6800
  • Fax: 916-481-1881
Mailing address:
  • Phone: 916-481-6800
  • Fax: 916-481-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA189887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: