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NPI Code Detail

MEDICARE: JENNIFER PALIVANICH

MEDICARE: JENNIFER PALIVANICH
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 Nurse95144774CA

General Provider Information

NPI Number : 1730651423
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER PALIVANICH
Provider Business Mailing Address
First Line : 7517 FLOWER MEADOW DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92126-1045
Country : US
Telephone Number : 858-775-7880
Fax Number :
Provider Business Practice Location Address
First Line : 7517 FLOWER MEADOW DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92126-1045
Country : US
Telephone Number : 858-775-7880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2018
Last Update Date : 12/19/2018

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Directions to “ JENNIFER PALIVANICH ” Practice Location

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