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General NPI Number Information
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NPI Number | 1457601742
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Entity Type | Individual
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Provider Name | JOSEFINA PENA
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Gender | Female
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 1607 E PALMDALE BLVD SUITE D
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City | PALMDALE
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State | CA
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Zip | 93550-4883
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Country | US
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Telephone | 661-233-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 5284 ADOLFO RD SUITE 100
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City | CAMARILLO
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State | CA
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Zip | 93012-6787
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Country | US
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Telephone | 805-289-0120
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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