Individual
JENNIFER LYNN PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9220 W SUNSET BLVD, SUITE 110, LOS ANGELES, CA 90069-3501
(310) 248-4010
(310) 248-4001
Mailing address
9220 W SUNSET BLVD STE 110, LOS ANGELES, CA 90069-3500
(310) 248-4010
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NPF 12752
CA
363LA2100X
Acute Care Nurse Practitioner
RN525621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDI-CAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
08/09/2012
Last updated
03/11/2013
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