Active NPI
Jennilee Tuazon, M.D.
- Psychiatry Physician
- Patton, CA
National Provider Identifier
1235454703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A129108
- Practice address
- 3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369 - Phone
- (909) 425-7679
- Fax
- (909) 425-6635
- NPI assigned
- Mar 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A129108 | CA | Primary |
Addresses
Primary practice location
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Mailing address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7679
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A129108 | CA | MD | Psychiatry Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Coalinga, CA
- NPI 1124078704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439510400000",
"number": "1235454703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 E. HIGHLAND AVENUE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "PATTON",
"state": "CA",
"postal_code": "92369",
"telephone_number": "909-425-7679",
"fax_number": "909-425-6635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3102 E. HIGHLAND AVENUE",
"address_2": "MEDICAL STAFF OFFICE",
"city": "PATTON",
"state": "CA",
"postal_code": "92369",
"telephone_number": "909-425-7679",
"fax_number": "909-425-6635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUAZON",
"first_name": "JENNILEE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-28",
"last_updated": "2015-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A129108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Patton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.