Healthcare Provider Details

I. General information

NPI: 1326580317
Provider Name (Legal Business Name): JENNIFER GEORGIA LYNN SABOVICH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GEORGIA SABOVICH RN

II. Dates (important events)

Enumeration Date: 11/08/2016
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9187 COCKATOO AVE
FOUNTAIN VALLEY CA
92708-6511
US

IV. Provider business mailing address

9187 COCKATOO AVE
FOUNTAIN VALLEY CA
92708-6511
US

V. Phone/Fax

Practice location:
  • Phone: 714-264-8555
  • Fax:
Mailing address:
  • Phone: 714-264-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number791337
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number791337
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number791337
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number791337
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number791337
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number791337
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number791337
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number791337
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number791337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: