Jennifer Huddleston, Physician Assistant PC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

JENNIFER HUDDLESTON, PHYSICIAN ASSISTANT PC

Doing business as

Thrive Wellness Center For Women

Practice address

1560 E Chevy Chase Dr Ste 200
Glendale, CA 91206-4140

Phone

(818) 470-6873

NPI assigned

Mar 27, 2020

Organization subpart

No

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

Authorized official

Name

Jennifer Huddleston, PA-CNPI 1962568865

Title

Physician Assistant

Phone

(818) 470-6873

Specialties & licenses 5

Addresses

Other names 1

• Thrive Wellness Center For Women Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Huddleston, PA

  • Medical Physician Assistant
  • Los Angeles, CA
  • NPI 1962568865
  NPD Authorized official

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1043848062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 MARILLA ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913432127",
            "telephone_number": "818-470-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E CHEVY CHASE DR STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064140",
            "telephone_number": "818-470-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER HUDDLESTON, PHYSICIAN ASSISTANT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "HUDDLESTON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "818-470-6873",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thrive Wellness Center For Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Jefferson, M.D.
• Karine Jeghelian, DC
• Jem Medical Group LLC (ME Healthcare)
• Penny Laine Jenkins, COTA/L
• Jennifer Herbert Dental Corporation
• Jenny Rehab Care Physical Therapy PC
• Alexander Keller Jensen, DO
• Soonjoo Jeong, LA.C, DIPL.AC.
• Hayk Jernazian, PSY.D.
• Levon Jernazian, PH.D.

• Gynecology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.