Individual
JEROME PENAFLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
2051 SHADETREE LN, ESCONDIDO, CA 92029-5304
(858) 354-6978
(760) 294-5595
Mailing address
2051 SHADETREE LN, ESCONDIDO, CA 92029-5304
(858) 354-6978
(760) 294-5595
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
195969
CA
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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