MEDICARE: JACLYN ROSE ARCOS

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
1	104100000X	Social Worker	125940	CA

General Provider Information

NPI Number	:	1891043659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYN ROSE ARCOS

Provider Business Mailing Address
First Line	:	PO BOX 1495
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-0495
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3680 E IMPERIAL HWY STE 220
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-2663
Country	:	US
Telephone Number	:	626-769-7174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	01/30/2025

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Directions to “ JACLYN ROSE ARCOS ” Practice Location

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