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General NPI Number Information
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NPI Number | 1639093511
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Entity Type | Individual
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Provider Name | JACQUELINE BRACHO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1900 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-2703
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Country | US
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Telephone | 209-526-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 2909 N 118TH ST STE 200
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City | OMAHA
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State | NE
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Zip | 68164-3643
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Country | US
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Telephone | 402-509-5532
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC021464
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License Number State | PA
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