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General NPI Number Information
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NPI Number | 1922400050
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Entity Type | Individual
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Provider Name | JAYNE KWON-CLAVADETSCHER APRN
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 911 E PLAZA BLVD
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3523
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Country | US
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Telephone | 619-434-0299
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Fax |
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Provider Business Mailing Address
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Address Line | 8077 FLORENCE AVE STE 112
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City | DOWNEY
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State | CA
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Zip | 90240-3894
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Country | US
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Telephone | 562-904-6031
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Fax | 562-905-6033
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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 | APRN-1790
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 95004414
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License Number State | CA
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