Jennifer Vergara Aguila, ARNP

Individual provider Active NPI Family Nurse Practitioner · San Mateo, CA

NPI 1437434693 · NPPES record last updated Mar 16, 2021

Key facts

NPI
1437434693
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
21338 (CA)
Practice address
951 Mariners Island Blvd Ste 300
San Mateo, CA 94404-1560
Phone
(772) 217-4557
Fax
(888) 352-7383
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21338CAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21338 CA Yes

Addresses

Primary practice location

951 Mariners Island Blvd Ste 300
San Mateo, CA 94404-1560

Mailing address

7240 E Yale Ave
Fresno, CA 93737-0007
Phone (904) 654-8725

Other providers in San Mateo, CA

All providers in San Mateo, CA · Family Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.