Healthcare Provider Details

I. General information

NPI: 1689510638
Provider Name (Legal Business Name): JACQUELINE NICOLE STERENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PENN ST
READING PA
19601-3973
US

IV. Provider business mailing address

3843 PARROT DR
ELLICOTT CITY MD
21042-4910
US

V. Phone/Fax

Practice location:
  • Phone: 610-796-8200
  • Fax:
Mailing address:
  • Phone: 443-844-1481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: