Healthcare Provider Details

I. General information

NPI: 1447068986
Provider Name (Legal Business Name): JENNIFER KING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20211 W VALLEY BLVD
TEHACHAPI CA
93561-6748
US

IV. Provider business mailing address

PO BOX 424
TEHACHAPI CA
93581-0424
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-5544
  • Fax:
Mailing address:
  • Phone: 559-799-2701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95034130
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95153767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: