Organization
JENNESS DIALYSIS LLC
Active
Other names
Hidden Valley Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1951 CITRACADO PKWY, ESCONDIDO, CA 92029-4158
(760) 746-0464
(760) 746-0402
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215443411
—
CA
Enumeration date
12/26/2017
Last updated
09/22/2025
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