Erin Marie Jensen, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

20506 Issued in CA

Practice address

859 E Foothill Blvd
Upland, CA 91786-4078

Phone

(909) 732-9576

NPI assigned

Sep 23, 2009

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1730413816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 HIMALAYAS CIRCLE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-732-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 E FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864078",
            "telephone_number": "909-732-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JC Max Pharmacy Inc
• Jeffrey D Ries D O a Professional Corporation
• Kevin M Jenkins, DO
• Stephanie D Jenniches, NP
• Jennifer Y. Kim MD Inc
• Marvin Fletcher Jensen, M.D.,D.D.S.
• Jerson Vasquez DDS Inc.
• Jesus Lua, MD, a Professional Medical Corporation
• Leena Josephin Jetty, MD
• Andrea Jimenez

• Physician Assistant in Upland, CA
• Providers in Upland, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.