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General NPI Number Information
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NPI Number | 1447182530
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Entity Type | Individual
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Provider Name | JENNA DE JONGE
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Gender | Female
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 7750 EL CAMINO REAL STE F
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City | CARLSBAD
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State | CA
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Zip | 92009-8517
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Country | US
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Telephone | 760-264-9466
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 KETTNER BLVD APT 501
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City | SAN DIEGO
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State | CA
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Zip | 92101-2560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95039850
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License Number State | CA
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