Jenniches, Stephanie D

Jenniches, Stephanie D is an individual health care provider with primary practice located at 999 San Bernardino Rd , Upland CA 91786-4920. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Jenniches, Stephanie D can be contacted via phone (909) 985-2811.

Contact Information

Primary practice address
999 San Bernardino Rd Upland CA 91786-4920
Phone: (909) 985-2811
Fax: (818) 587-2493
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP9412 California

Profile Details

NPI number 1114940988
LBN Legal business name Jenniches, Stephanie D
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114940988 NPPES
California MEDICAID RN513294

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