Jenna K Timboe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A134953 Issued in CA

Practice address

1300 Avenida Vista Hermosa Ste 200
San Clemente, CA 92673-6338

Phone

(949) 429-7700

Fax

(949) 429-7704

NPI assigned

May 7, 2013

Last updated

Jul 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Specialists of Orange County

  • Emergency Medicine Physician
  • Orange, CA
  • NPI 1740214733
  Medicare reassignment NPD
• University of California Irvine

  dba UCI Family Health Center - Anaheim

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1598790529
  Medicare reassignment NPD
• University of California Irvine

  dba UCI Health - Irvine MC Outpatient Pharmacy

  • Pharmacy
  • Irvine, CA
  • NPI 1669344339
  NPD
• University of California Irvine

  dba UCI Family Health Center - Santa Ana

  • Federally Qualified Health Center (FQHC)
  • Santa Ana, CA
  • NPI 1851325906
  NPD
• Children's Hospital at Mission

  dba Rady Children's Hospital

  • Children's Hospital
  • Mission Viejo, CA
  • NPI 1699868398
  NPD (past)
• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Pediatric Subspecialty Faculty, Inc.

  • Pediatrics Physician
  • Orange, CA
  • NPI 1790850279
  NPD (past)
• University of California Irvine

  dba Uci Health

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1114362894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST",
            "address_2": "SUITE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684509",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 AVENIDA VISTA HERMOSA STE 200",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736338",
            "telephone_number": "949-429-7700",
            "fax_number": "949-429-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBOE",
        "first_name": "JENNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A134953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114362894",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Talia Tomasin, PA-C
• Nhu Quynh Tran, D.D.S.

• Pediatrics Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.