JACQUELINE JEAN WOLAK FNP DNP NPI 1962865519

NPI Information

NPI: 1962865519
Provider Name: JACQUELINE JEAN WOLAK, FNP, DNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
7910 FROST ST
SAN DIEGO, CA
ZIP 92123
Phone: (858) 966-8574
Get Directions

Jacqueline Jean Wolak, FNP, DNP is a family nurse practitioner in San Diego, CA. Jacqueline Jean Wolak, FNP, DNP NPI is 1962865519. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7910 FROST ST
SAN DIEGO, CA
ZIP 92123-771
Phone: (858) 966-8574

The NPI 1962865519 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2016 and was last updated on 3/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		209014197	ILLINOIS	No
2	363LF0000X	Nurse Practitioner	Family	NP95023785	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	041408764	OTHER	ILLINOIS	041408764
2	209014197	OTHER	ILLINOIS	209014197

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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