Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackeline Lucia Sepulveda, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790424968

Jackeline Lucia Sepulveda, PA is a Physician Assistant in Gilbert, Arizona. Qualified in 2022, 4 years ago. Practices with Banner Cancer Center Specialists LLC, a 338-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Gilbert, AZ
Fax: (480) 256-4734

No coordinates on file. Search this address in Google Maps

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9903 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790424968
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 3, 2022
Last updated in NPPESFebruary 14, 2025
Certification dateNovember 22, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Banner Cancer Center Specialists Llc — 338 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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