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General NPI Number Information
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NPI Number | 1548182181
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Entity Type | Individual
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Provider Name | JACQUELYN PONEK
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Gender | Female
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 5601 WEST MALL
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City | ATASCADERO
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State | CA
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Zip | 93422-4234
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Country | US
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Telephone | 805-462-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 4805 SANTA CRUZ RD
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City | ATASCADERO
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State | CA
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Zip | 93422-1435
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Country | US
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Telephone | 805-712-1292
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 844548
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License Number State | CA
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