JENNA PETTUS (NPI# 1376033746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376033746 |
| Entity Type | Individual |
| Full Name | JENNA PETTUS |
| Credential | NP |
| Practice Address |
711 14th St Apt 11 Sacramento CA 95814 |
| Mailing Address |
711 14th St Apt 11 Sacramento CA 95814-1922 |
| Practice Telephone | 9256835410 |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95009041 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
711 14TH ST APT 11 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801435631 | County of Sacramento | Clinic/Center | 651 I Street, Sacramento, CA 95814 | 2019-12-26 |
| 1306269667 | First Advocate Home Care | In Home Supportive Care | 1215 K Street, 17th Floor, Sacramento, CA 95814 | 2014-01-22 |
| 1063752350 | Brian C. Steele Dds A Professional Corporation | Dentist | 1105 E Street, Sacramento, CA 95814 | 2013-02-22 |
| 1265777692 | Wellspace Health | Clinic/Center | 631 H St, Sacramento, CA 95814 | 2012-12-12 |
| 1407117823 | Richard Lee Bauer | Internal Medicine | 651 I St., Sacramento, CA 95814 | 2012-06-01 |
| 1851669949 | Heaaring Healthcare Provider of California | Audiologist | One Capitol Mall, Suite 320, Sacramento, CA 95814 | 2011-12-05 |
| 1114254935 | Robert D Canning | Psychologist | 501 J Street, Suite 530, California Department of Corrections & Rehabilitation, Sacramento, CA 95814 | 2009-11-16 |
| 1407035488 | Donald Herbert Hodges | Case Manager/Care Coordinator | 1420 E Street Apt # B, Sacramento, CA 95814 | 2007-10-26 |
| 1255537536 | River Oak Center for Children | Clinic/Center | 1238 S Street, Sacramento, CA 95814 | 2007-06-25 |
| 1467664086 | Victoria Ramirez | Social Worker | 1611 S Street, #101, Sacramento, CA 95814 | 2007-05-04 |
| Find all providers in zip 95814 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023633500 | Mary Cobleigh Banfield | Nurse Practitioner | 1009 1/2 T St, Sacramento, CA 95811-6560 | 2020-06-10 |
| 1952926438 | Perla Zuliana Aguayo Vazquez | Nurse Practitioner | 3520 El Ricon Way, Sacramento, CA 95864-2915 | 2020-06-10 |
| 1043834302 | Lacey Elizabeth Watson | Nurse Practitioner | 3710 J St Ste 201, Sacramento, CA 95816-5519 | 2020-06-02 |
| 1467081513 | Meeri Kim | Nurse Practitioner | 2425 Alhambra Blvd Ste 250, Sacramento, CA 95817-1110 | 2020-04-01 |
| 1134763238 | Mary Dicou | Nurse Practitioner | 1747 N Market Blvd, Sacramento, CA 95834-2978 | 2019-10-31 |
| 1265099030 | Christopher Adam Phillips | Nurse Practitioner | 2801 Unity Pointe Ave, Sacramento, CA 95833-3772 | 2019-05-28 |
| 1669942538 | Inna Dariychuk | Nurse Practitioner | 500 Howe Avenue, Suite 100, Sacramento, CA 95825 | 2018-12-04 |
| 1770091621 | Rane Nathan Beal | Nurse Practitioner | 209 29th St Ste B, Sacramento, CA 95816-3271 | 2018-01-12 |
| 1730698846 | Olivia Rapozo | Nurse Practitioner | 4860 Y St # 3400, Sacramento, CA 95817-2307 | 2017-09-21 |
| 1851811624 | Christine Joy Pacis Bangalan | Nurse Practitioner | 5762 La Venta Way, Sacramento, CA 95835-2406 | 2017-06-22 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95814 |
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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.