Jacqueline Otake
Nurse Anesthetist, Certified Registered in Albuquerque, New Mexico
1720769763- Practice location
- 1100 Central Ave SE, Albuquerque, NM 87106-4930
- Phone
- 505-841-1234
- Fax
- —
- Last updated
- July 16, 2026
Jacqueline Otake is a Nurse Anesthetist, Certified Registered based in Albuquerque, NM. Jacqueline Otake practices in Albuquerque, NM. The NPI Number for Jacqueline Otake is 1720769763 and holds a License No. 1229584 (TX). The current practice location address for Jacqueline Otake is 1100 Central Ave SE, Albuquerque, NM 87106-4930 and can be reached out via phone at 505-841-1234.
Provider Profile Details
- NPI Number
- 1720769763
- Provider Name
- Jacqueline Otake
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1100 Central Ave SE, Albuquerque, NM 87106-4930
- Phone Number
- 505-841-1234
- Primary Taxonomy
- Nurse Anesthetist, Certified Registered · 367500000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 31, 2023
- Last Update Date
- July 16, 2026
- Certification Date
- July 16, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1100 Central Ave SE
Albuquerque, NM 87106-4930 - City
- Albuquerque
- State
- New Mexico
- Zip
- 87106-4930
- Phone Number
- 505-841-1234
Provider Business Mailing Address Details
- Address
- 8770 Washington Blvd Apt 420
Culver City, CA 90232-2482 - City
- Culver City
- State
- CA
- Zip
- 90232-2482
- Phone Number
- 860-519-6073
License Information
- License Number (1)
- 1229584
- License State (1)
- TX
- Taxonomy (1)
- Nurse Anesthetist, Certified Registered · 367500000X · Primary
- License Number (2)
- 80042
- License State (2)
- NM
- Taxonomy (2)
- Nurse Anesthetist, Certified Registered · 367500000X
- License Number (3)
- 114672-23
- License State (3)
- NH
- Taxonomy (3)
- Nurse Anesthetist, Certified Registered · 367500000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nurse Anesthetist, Certified Registered providers near Albuquerque, NM
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Frequently Asked Questions
What is the NPI number of Jacqueline Otake?
The NPI number of Jacqueline Otake is 1720769763. It was assigned on July 31, 2023 and is currently active in the NPPES registry.
What is the specialty of Jacqueline Otake?
Jacqueline Otake is registered under the primary taxonomy Nurse Anesthetist, Certified Registered (code 367500000X), licensed in TX under license number 1229584.
Where does Jacqueline Otake practice?
The practice location is 1100 Central Ave SE, Albuquerque, NM 87106-4930. The office can be reached at 505-841-1234 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1720769763 directly on the NPPES registry website.