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NPI Code Detail

MEDICARE: MS. JENNIFER L COMMANDER N.P.

MEDICARE: MS. JENNIFER L COMMANDER N.P.
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
1163W00000XRegistered NurseRN625651CA
2363LF0000XFamily Nurse Practitioner16351CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN625651OTHERCAMED LICENSE
2NP16351OTHERCAMED LICENSE

General Provider Information

NPI Number : 1063421741
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER L COMMANDER N.P.
Provider Business Mailing Address
First Line : 2925 PUESTA DEL SOL
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-3007
Country : US
Telephone Number : 805-705-4663
Fax Number :
Provider Business Practice Location Address
First Line : 2925 PUESTA DEL SOL
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-3007
Country : US
Telephone Number : 805-705-4663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 07/24/2007

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