Bloom, Jacqueline

Bloom, Jacqueline is an sole proprietor health care provider with primary practice located at 1 Rock Ridge Rd , Fairfax CA 94930-1413. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Bloom, Jacqueline can be contacted via phone (415) 342-0964.

Contact Information

Primary practice address
1 Rock Ridge Rd Fairfax CA 94930-1413
Phone: (415) 342-0964
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X

Profile Details

NPI number 1730672338
LBN Legal business name Bloom, Jacqueline
Credentials MS OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2018
Last updated Dec 16th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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