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

Jacqueline Licauco, NP

Individual provider Family Nurse Practitioner · NPI 1467857284

Jacqueline Licauco, NP is a Nurse Practitioner in Burbank, California. Qualified in 2014, 12 years ago. Practices with Providence Facey Medical Foundation, a 323-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2014
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

191 S Buena Vis Ste 100
Burbank, CA 91505-4554
Phone: (818) 869-7600
Fax: (814) 433-3691
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 811 N Doan Dr, Burbank, CA 91506-1523 — (818) 441-9270

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95000859 (CA)

Record details

NPI number1467857284
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedOctober 23, 2014
Last updated in NPPESJune 15, 2026
Certification dateJune 15, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Providence Facey Medical Foundation — 323 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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