Jennifer Park

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Practice address

1840 Ventura Blvd
Camarillo, CA 93010-7848

Phone

(805) 482-4848

NPI assigned

Dec 16, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1033757455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930107848",
            "telephone_number": "805-482-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930107848",
            "telephone_number": "805-482-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.artisticwigs.com",
            "affiliation": "N",
            "address_1": "1840 Ventura Blvd",
            "city": "Camarillo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930107848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Paredes
• Jessica Paredes
• Craig Randall Parent, DPM
• Leah Rachel Barczi Parisi, DPT
• Arris Park, OD
• Megumi Parker
• Bonnie Parkin
• Jessica Renee Sullivan Parks
• Flavia Antonela Parra Costales
• Kelley Parrow, PPS

• Customized Equipment (DME) in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.