Provider Demographics
NPI:1740166404
Name:MCGREGOR, JACQUELINE ROSE
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ROSE
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 S CURRYER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7102
Mailing Address - Country:US
Mailing Address - Phone:805-878-9644
Mailing Address - Fax:
Practice Address - Street 1:750 MEEHAN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-7300
Practice Address - Country:US
Practice Address - Phone:805-361-6500
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician