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General NPI Number Information
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NPI Number | 1871315739
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Entity Type | Individual
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Provider Name | JENNA DINEEN PASSARINI FNP, APRN
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 101 THE CITY DR S
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City | ORANGE
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State | CA
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Zip | 92868-3201
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Country | US
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Telephone | 626-482-9425
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Fax |
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Provider Business Mailing Address
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Address Line | 848 SAN DIEGO LN
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City | PLACENTIA
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State | CA
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Zip | 92870-6219
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Country | US
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Telephone | 626-482-9425
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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 | 95030971
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License Number State | CA
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