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General NPI Number Information
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NPI Number | 1891827812
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Entity Type | Individual
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Provider Name | JACQUELINE BROUGHTON D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 6000 FAIRWAY DR SUITE 1
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City | ROCKLIN
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State | CA
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Zip | 95677-4244
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Country | US
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Telephone | 916-259-1732
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Fax |
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Provider Business Mailing Address
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Address Line | 2351 SUNSET BLVD SUITE 170-237
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City | ROCKLIN
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State | CA
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Zip | 95765-4338
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Country | US
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Telephone | 408-621-6194
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 19394
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License Number State | CA
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