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NPI Code Detail

MEDICARE: DANE ERIK JENSEN

MEDICARE: DANE ERIK JENSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician95226097CA

General Provider Information

NPI Number : 1487517496
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANE ERIK JENSEN
Provider Business Mailing Address
First Line : 3635 OAK CLIFF DR
Second Line :
City : FALLBROOK
State : CA
Zip : 92028-9414
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1664 BROADWAY
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5201
Country : US
Telephone Number : 619-579-8685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2025
Last Update Date : 12/05/2025

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Directions to “ DANE ERIK JENSEN ” Practice Location

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