Provider Demographics
NPI:1629954482
Name:SAAVEDRA, JACQUELINE L (N/A)
Entity type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:L
Last Name:SAAVEDRA
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:JACKIE
Other - Middle Name:
Other - Last Name:SAAVEDRA ALDANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1179 E RIDGEROCK ST
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6579
Mailing Address - Country:US
Mailing Address - Phone:818-468-2497
Mailing Address - Fax:
Practice Address - Street 1:1179 E RIDGEROCK ST
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6579
Practice Address - Country:US
Practice Address - Phone:818-468-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter