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General NPI Number Information
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NPI Number | 1447149331
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Entity Type | Individual
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Provider Name | JACQUELYN JANE CHAU DDS
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Gender | Female
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 680 BANCROFT AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-2904
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Country | US
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Telephone | 510-569-0218
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Fax |
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Provider Business Mailing Address
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Address Line | 43984 ROSEMERE DR
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City | FREMONT
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State | CA
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Zip | 94539-5966
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Country | US
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Telephone | 510-396-7472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 111787
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License Number State | CA
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