JENNIFER MIRANDA VICENTE (NPI# 1235522483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235522483 |
| Entity Type | Individual |
| Full Name | JENNIFER MIRANDA VICENTE |
| Credential | NP |
| Practice Address |
3300 E South St Ste 205 Lakewood CA 90805-4587 |
| Mailing Address |
6742 Glorywhite St Lakewood CA 90713-2222 |
| Practice Telephone | 5625310377 |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
NP95002008 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
NP95002008 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699954743 | Jennifer Ann Vicente | Dentist | 1157 Professional Park Dr, Building #13, Brandon, FL 33511-4887 | 2007-10-25 |
| 1376994277 | Jennifer Ann Vicente | Optometrist | 2050 Pfingsten Rd Ste 280, Glenview, IL 60026 | 2016-06-22 |
| Street Address |
3300 E SOUTH ST STE 205 |
| City | LAKEWOOD |
| State | CA |
| Zip Code | 90805-4587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154928 | Makando Mutanda | Counselor | 161 West Victoria St., Long Beach, CA 90805 | 2019-10-02 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1609345925 | Belmont Rx LLC | Pharmacy | 6583 Atlantic Ave., 1st Floor Ste 109, Long Beach, CA 90805 | 2018-11-15 |
| 1508359605 | Mykayla Rowley | Case Manager/Care Coordinator | 5190 Atlatic Ave, Long Beach, CA 90805 | 2018-06-13 |
| 1942728589 | Marissa Liana Cabral | Social Worker | 5190 Atantic Ave, Long Beach, CA 90805 | 2017-09-04 |
| 1245757673 | Karina Vasquez | Licensed Vocational Nurse | 1325 E Poppy St, Long Beach, CA 90805 | 2017-08-25 |
| 1376060277 | Rebekkah Dawn Williams | Counselor | 100 East Market Street, Long Beach, CA 90805 | 2017-08-23 |
| 1871038919 | Andrea Dabbs | Pharmacist | 3700 E. South St., Lakewood, CA 90805 | 2016-12-28 |
| 1164972360 | Young Men's Christian Association of Greater Long Beach | Health Educator | 4949 Atlantic Ave, Long Beach, CA 90805 | 2016-10-12 |
| 1043662158 | Kristina Eunjeong Chang | Podiatrist | 3700 E South Street, Lakewood, CA 90805 | 2016-07-13 |
| Find all providers in zip 90805 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477997666 | Melanie Rose Vernacchia | Nurse Practitioner | 600 River Ave Fl 3, Lakewood, NJ 08701-5237 | 2013-04-18 |
| 1245576834 | Regina B Glisson | Nurse Practitioner | 101 Second St, Lakewood, NJ 08701 | 2012-12-31 |
| 1982818803 | Linda J Leblanc | Nurse Practitioner | 10814 Deepwood Dr Sw, Lakewood, WA 98498 | 2007-05-09 |
| 1982704441 | Nancy Irene Brooker | Nurse Practitioner | 11700 W 2nd Pl Ste 450, Lakewood, CO 80228-1719 | 2006-09-25 |
| 1447712781 | Olanrewaju Famakinwa | Nurse Practitioner | 685 River Ave, Lakewood, NJ 08701-5288 | 2019-04-04 |
| 1285144758 | Ann Pereira | Nurse Practitioner | 1526 Cole Blvd Ste 300, Lakewood, CO 80401-3410 | 2017-10-10 |
| 1235648890 | Natalia C Spencer | Nurse Practitioner | 1526 Cole Blvd Ste 300, Lakewood, CO 80401-3410 | 2017-09-27 |
| 1679096630 | Amber Brooke Hyland | Nurse Practitioner | 13900 Detroit Ave, Lakewood, OH 44107-4624 | 2017-07-21 |
| 1518496991 | Frank Ross Arnp LLC | Nurse Practitioner | 4901 108th St Sw, Lakewood, WA 98499-3724 | 2017-06-08 |
| 1235672916 | Marilou Cruz | Nurse Practitioner | 685 River Ave, Suite 3, Lakewood, NJ 08701-5288 | 2016-11-29 |
| Find all providers in LAKEWOOD | ||||
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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.