Individual
MS. JENNIFER MARIE CORREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., N.P., CNS
Contact information
Practice address
200 MEDICAL PLAZA STE 214, LOS ANGELES, CA 90095
(310) 825-6078
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
437292
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
20034
CA
364S00000X
Clinical Nurse Specialist
3454
CA
Other
Enumeration date
12/03/2010
Last updated
07/11/2018
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