Provider Demographics
NPI:1154004539
Name:HIMELFARB, JAQUELINE RODRIGUES (NCS)
Entity type:Individual
Prefix:
First Name:JAQUELINE
Middle Name:RODRIGUES
Last Name:HIMELFARB
Suffix:
Gender:F
Credentials:NCS
Other - Prefix:
Other - First Name:JAQUELINE
Other - Middle Name:
Other - Last Name:RODRIGUES JOAQUIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1447 TREAT BLVD APT 112
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-7913
Mailing Address - Country:US
Mailing Address - Phone:202-937-7606
Mailing Address - Fax:
Practice Address - Street 1:1447 TREAT BLVD APT 112
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-7913
Practice Address - Country:US
Practice Address - Phone:202-937-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174400000XOther Service ProvidersSpecialist