Jessica Marie Kennedy, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95026236 Issued in CA

Practice address

6401 Fay Ranch Rd
Weldon, CA 93283-9735

Phone

(760) 378-4000

NPI assigned

Oct 5, 2020

Last updated

Oct 5, 2020By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• South Fork Union School District

  • Local Education Agency (LEA)
  • Weldon, CA
  • NPI 1619153004
  NPD (past)

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1659978534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 KELSO VALLEY RD",
            "city": "WELDON",
            "state": "CA",
            "postal_code": "932839564",
            "telephone_number": "760-378-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FAY RANCH RD",
            "city": "WELDON",
            "state": "CA",
            "postal_code": "932839735",
            "telephone_number": "760-378-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 Kelso Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Weldon",
            "state": "CA",
            "postal_code": "932839564",
            "country_code": "US",
            "telephone_number": "760-378-4000 x257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95026236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Bulgarelli, PA-C
• Mary Silvio Conner, MSW, PPSC
• Ladonna Kay Jaujou, MA PPS
• Jackelyn Nicole Ray, RN, BSN
• South Fork Union School District

• Registered Nurse in Weldon, CA
• Providers in Weldon, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.