Sullivan, Jenifer Rezende

Sullivan, Jenifer Rezende is an individual health care provider with primary practice located at 732 Mott Street 100-110, San Fernando CA 91340-4237. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Sullivan, Jenifer Rezende can be contacted via phone (818) 963-5690.

Contact Information

Primary practice address
732 Mott Street 100-110 San Fernando CA 91340-4237
Phone: (818) 963-5690
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95011562 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP95011562 California

Profile Details

NPI number 1326501503
LBN Legal business name Sullivan, Jenifer Rezende
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2019
Last updated Oct 10th, 2023 - about last year

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 1326501503 NPPES
California MEDICAID 95011562

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