Healthcare Provider Details

I. General information

NPI: 1245103407
Provider Name (Legal Business Name): JAILINE ORDUNO DAMIAN CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 LEWELLING BLVD
ASHLAND CA
94580-1632
US

IV. Provider business mailing address

268 LEWELLING BLVD
ASHLAND CA
94580-1632
US

V. Phone/Fax

Practice location:
  • Phone: 916-628-0851
  • Fax:
Mailing address:
  • Phone: 916-628-0851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number01351854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: