Physician Compare National (NPI:1952318537)

HEALTHCARE PROVIDER: JENNELL JOE BOCKENSTEDT OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1952318537
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103822770
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061005000152
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOCKENSTEDT
	Individual professional last name
Provider First Name	JENNELL
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	OD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MARINA OPTOMETRIC CENTER INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5193876522
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	48 W ROMIE LN
	Group Practice or individual's line 1 address
City	SALINAS
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	939012317
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8314240834
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y