Provider Demographics
NPI:1578364949
Name:LEIMBACH, JACQUELINE (DACM)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:LEIMBACH
Suffix:
Gender:
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 SAN ROQUE DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-7016
Mailing Address - Country:US
Mailing Address - Phone:619-920-3811
Mailing Address - Fax:
Practice Address - Street 1:4295 GESNER ST STE 3F
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6667
Practice Address - Country:US
Practice Address - Phone:619-920-3811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist