Healthcare Provider Details

I. General information

NPI: 1073322681
Provider Name (Legal Business Name): JACQUILINE W NJAGI-BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 CARMEL CREEK RD APT 366
SAN DIEGO CA
92130-2809
US

IV. Provider business mailing address

11800 CARMEL CREEK RD APT 366
SAN DIEGO CA
92130-2809
US

V. Phone/Fax

Practice location:
  • Phone: 619-248-1195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: