Healthcare Provider Details

I. General information

NPI: 1043792179
Provider Name (Legal Business Name): JENNIFER DURAN OCAMPO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 1ST ST
BAKERSFIELD CA
93304-2901
US

IV. Provider business mailing address

1611 1ST ST
BAKERSFIELD CA
93304-2901
US

V. Phone/Fax

Practice location:
  • Phone: 661-336-5300
  • Fax: 661-336-5303
Mailing address:
  • Phone: 661-336-5300
  • Fax: 661-336-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95009869
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: