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NPI Code Detail

MEDICARE: MISS JENNIFER MARIE BARTLETT

MEDICARE: MISS JENNIFER MARIE BARTLETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1126800000XDental Assistant50653CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013436179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER MARIE BARTLETT
Provider Business Mailing Address
First Line : 42885 WOODSIDE CT
Second Line :
City : HEMET
State : CA
Zip : 92544-3369
Country : US
Telephone Number : 951-775-5332
Fax Number :
Provider Business Practice Location Address
First Line : 12121 WILSHIRE BLVD STE 1111
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1188
Country : US
Telephone Number : 951-775-5332
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2017
Last Update Date : 07/21/2022

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Directions to “ MISS JENNIFER MARIE BARTLETT ” Practice Location

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