Healthcare Provider Details

I. General information

NPI: 1538349477
Provider Name (Legal Business Name): OSWALD ERLAND JAUWENA N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 DOLBEER ST
EUREKA CA
95501-4736
US

IV. Provider business mailing address

2710 DOLBEER ST
EUREKA CA
95501-4736
US

V. Phone/Fax

Practice location:
  • Phone: 626-349-0492
  • Fax: 707-267-2061
Mailing address:
  • Phone: 626-349-0492
  • Fax: 707-267-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number15842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: