STEPHANIE D JENNICHES (NPI# 1114940988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114940988 |
| Entity Type | Individual |
| Full Name | STEPHANIE D JENNICHES |
| Credential | NP |
| Practice Address |
999 San Bernardino Rd Upland CA 91786-4920 |
| Mailing Address |
Po Box 4419 Woodland Hills CA 91365-4419 |
| Practice Telephone | 9099852811 |
| Practice Fax Number | 8185872493 |
| Mailing Telephone | 8183409988 |
| Mailing Fax Number | 8185872493 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | NP9412 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RN513294 | 05 |
| Street Address |
999 SAN BERNARDINO RD |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-4920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780681189 | San Antonio Regional Hospital | General Acute Care Hospital | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2005-06-30 |
| 1922643931 | Angie Ling | Physician Assistant | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-11-13 |
| 1326683582 | Wendy Karina Barreto II | General Practice | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-11-12 |
| 1942843511 | Chen Liang | Physician Assistant | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-10-25 |
| 1780225359 | Rebecca Ann Paquette | Registered Nurse | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-10-03 |
| 1902378979 | Michael S Yeh | Physician Assistant | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2019-01-01 |
| 1629563044 | Christine Le Dang | Nurse Practitioner | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2018-06-27 |
| 1487169041 | Junghwa Kim | Pharmacist | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2017-12-05 |
| 1790298958 | Sarah Shin | Physical Therapist | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2017-11-09 |
| 1063922284 | Dulce R De Castro M D A Professional Corporation | Pathology | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2017-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699241265 | Alexander Knipper | Nurse Practitioner | 1334 N Benson Ave # 3, Upland, CA 91786-2168 | 2018-10-22 |
| 1528559697 | Anne E Campbell | Nurse Practitioner | 1809 S Main Street, Upland, IN 46989 | 2018-05-24 |
| 1104367135 | Theresa Davis-bates | Nurse Practitioner | 141 W Foothill Blvd, Upland, CA 91786-8705 | 2017-03-09 |
| 1003195827 | Stephanie J Rasmussen | Nurse Practitioner | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2011-08-10 |
| 1366749418 | Christina Davidyock | Nurse Practitioner | 1 Medical Center Blvd, Upland, PA 19013 | 2011-02-24 |
| 1205158649 | Tonya M Santiago | Nurse Practitioner | 999 San Bernardino Rd, Upland, CA 91786-4920 | 2010-02-26 |
| 1952635237 | Marjan Khaleghi | Nurse Practitioner | 974 W Foothill Blvd, Upland, CA 91786-3728 | 2009-09-20 |
| 1841425279 | Jody A Bouma | Nurse Practitioner | 1113 Alta Ave Ste 220, Upland, CA 91786-2803 | 2009-05-29 |
| 1366689762 | Yvonne Schwetz | Nurse Practitioner | 1113 Alta Ave Ste 220, Upland, CA 91786-2803 | 2009-01-07 |
| 1831346907 | Jeffrey Thomas Straley | Nurse Practitioner | 1100 San Bernardino Road, Suite 1100, Upland, CA 91786-4952 | 2008-08-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.