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NPI Code Detail

MEDICARE: JENNIFER LYNN BARCZYKOWSKI

MEDICARE: JENNIFER LYNN BARCZYKOWSKI
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1790839884
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN BARCZYKOWSKI
Provider Business Mailing Address
First Line : 2007 PLANT AVE
Second Line : REAR
City : REDONDO BEACH
State : CA
Zip : 90278-1912
Country : US
Telephone Number : 310-844-3154
Fax Number :
Provider Business Practice Location Address
First Line : 815 N EL CENTRO AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90038-3805
Country : US
Telephone Number : 323-463-2119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 07/08/2007

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