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General NPI Number Information
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NPI Number | 1538528518
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Entity Type | Individual
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Provider Name | JOVAN VERNON TRENT MSN, CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 1800 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204
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Country | US
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Telephone | 509-720-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 505 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2204
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Country | US
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Telephone | 415-883-0944
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Fax | 415-476-9516
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 95000485
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License Number State | CA
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