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General NPI Number Information
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NPI Number | 1619815958
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Entity Type | Organization
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Legal Business Name | JEEIRENE ADVANCED NURSING, INC
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 362 PIPPIN DR
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City | FALLBROOK
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State | CA
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Zip | 92028-3485
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Country | US
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Telephone | 442-637-2634
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Fax | 760-557-7428
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Provider Business Mailing Address
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Address Line | 362 PIPPIN DR
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City | FALLBROOK
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State | CA
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Zip | 92028-3485
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Country | US
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Telephone | 442-637-2634
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Fax | 760-557-7428
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEE ESTAVILLA
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Credential | PMHNP-BC
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Telephone | 442-637-2634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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