Healthcare Provider Details

I. General information

NPI: 1710897798
Provider Name (Legal Business Name): JENNA LAUREL HARMON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E LATHAM AVE
HEMET CA
92543-4364
US

IV. Provider business mailing address

25840 JUNIPER FLATS RD
HOMELAND CA
92548-9324
US

V. Phone/Fax

Practice location:
  • Phone: 909-825-7084
  • Fax: 951-900-2053
Mailing address:
  • Phone: 949-412-4106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number727051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: