Individual provider Active NPI

Jenna Bre Marquez, LVN

  • Skilled Nursing Facility
  • San Diego, CA
National Provider Identifier
1356584882
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
233758 Issued in CA
Practice address
3373 Kearny Villa LN
San Diego, CA 92123-1911
Phone
(858) 336-2278
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 233758 CA Primary

Addresses

Primary practice location

3373 Kearny Villa LN
San Diego, CA 92123-1911

Mailing address

3373 Kearny Villa Lane
San Diego, CA 92123
Phone (858) 336-2278

Other names 1

  • Jenna Archibald Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
233758CAMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1356584882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3373 KEARNY VILLA LANE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-336-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3373 KEARNY VILLA LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231911",
            "telephone_number": "858-336-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "JENNA",
        "middle_name": "BRE",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "233758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "ARCHIBALD",
            "credential": "LVN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; 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.