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General NPI Number Information
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NPI Number | 1598524498
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Entity Type | Individual
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Provider Name | JEANELLE MAGLANOC ONG NP
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Gender | Female
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 16100 SAND CANYON AVE STE 240
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City | IRVINE
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State | CA
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Zip | 92618-3724
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Country | US
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Telephone | 949-636-1858
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Fax |
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Provider Business Mailing Address
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Address Line | 18617 KLUM PL
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-4854
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Country | US
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Telephone | 626-512-4713
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95027704
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95027704
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License Number State | CA
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