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NPI Code Detail

MEDICARE: JACQUELINE OLAES

MEDICARE: JACQUELINE OLAES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1427906130
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE OLAES
Provider Business Mailing Address
First Line : 3550 CAMINO DEL RIO N STE 305
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1740
Country : US
Telephone Number : 619-756-4095
Fax Number : 619-514-1026
Provider Business Practice Location Address
First Line : 3550 CAMINO DEL RIO N STE 305
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1740
Country : US
Telephone Number : 619-756-4095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ JACQUELINE OLAES ” Practice Location

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