Sutherland, Jackline Shinyonya

Sutherland, Jackline Shinyonya is an sole proprietor health care provider with primary practice located at 320 E Palmdale Blvd , Palmdale CA 93550-4598. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Sutherland, Jackline Shinyonya can be contacted via phone (661) 526-4766.

Contact Information

Primary practice address
320 E Palmdale Blvd Palmdale CA 93550-4598
Phone: (661) 526-4766
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP 3442 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R2068891 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95011529 California

Profile Details

NPI number 1861882029
LBN Legal business name Sutherland, Jackline Shinyonya
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 27th, 2015
Last updated Jan 26th, 2021 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1861882029 NPPES
California MEDICAID 1537966505

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