Individual
NATISHA NICOLE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
510 SUPERIOR AVE STE 200G, NEWPORT BEACH, CA 92663-3664
(949) 791-6767
(949) 791-6768
Mailing address
510 SUPERIOR AVE STE 200G, NEWPORT BEACH, CA 92663-3664
(949) 791-6767
(949) 791-6768
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34527
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16957
BLUE CROSS BLUE SHIELD
IA
01
—
246930
MIDLANDS CHOICE
IA
05
—
5266486
—
IA
01
—
IA0104
JOHN DEERE
IA
Enumeration date
12/02/2005
Last updated
07/21/2020
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