Healthcare Provider Details

I. General information

NPI: 1215722244
Provider Name (Legal Business Name): JENNIFER TREJO ROJO CPH, CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

1005 SW 35TH PL
MOORE OK
73160-1260
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-5400
  • Fax:
Mailing address:
  • Phone: 405-833-7331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number39995
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number21167
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: