Healthcare Provider Details

I. General information

NPI: 1689810897
Provider Name (Legal Business Name): JENNIFER MARIE ORNITZ CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

1237 GRAVES AVE APT. 107
EL CAJON CA
92021-8979
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7000
  • Fax:
Mailing address:
  • Phone: 619-871-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: