Provider Demographics
NPI:1285781492
Name:LOSI-SASAKI, JACQUELINE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:MARIE
Last Name:LOSI-SASAKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:MARIE
Other - Last Name:LOSI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:270 COHASSET RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2262
Mailing Address - Country:US
Mailing Address - Phone:530-895-1396
Mailing Address - Fax:530-895-0262
Practice Address - Street 1:270 COHASSET RD STE 100
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2262
Practice Address - Country:US
Practice Address - Phone:530-895-1396
Practice Address - Fax:530-895-0262
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19784207N00000X
TXM3007207N00000X
CAC55886207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology