Individual
MS. JENNIFER PONGPUNGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
335 E AVENUE I STE 24, LANCASTER, CA 93535-1916
(661) 471-4561
Mailing address
335 E AVENUE I, LANCASTER, CA 93535-1916
(661) 471-4360
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
542305
CA
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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