| Doctor Name: | JACKLEN JAMEL KHURI |
| NPI Number: | 1013353671 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 671397 |
| Business Practice Address: | 21641 Canada Rd Apt 19e Lake Forest, CA - 926302774 |
| Business Phone Number: | 9093804419 |
| Business Fax Number: | |
| Mailing Address: | 21641 Canada Rd Apt 19e, LAKE FOREST |
| State: | CA |
| Postal Code: | 926302774 |
| Phone Number: | 9093804419 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2013 |
| NPI Last Update Date: | 05/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | 671397 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |