Jennifer Rachael Surgener, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15194 Issued in CA

Practice address

14642 Newport Ave
Suite #200
Tustin, CA 92780-6057

Phone

(714) 669-4466

Fax

(714) 669-4088

NPI assigned

Jul 21, 2008

Last updated

Jul 21, 2008By 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

Other names 1

• Jennifer Rachael Moss Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1801051826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE",
            "address_2": "SUITE #200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806057",
            "telephone_number": "714-669-4466",
            "fax_number": "714-669-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE",
            "address_2": "SUITE #200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806057",
            "telephone_number": "714-669-4466",
            "fax_number": "714-669-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURGENER",
        "first_name": "JENNIFER",
        "middle_name": "RACHAEL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MOSS",
            "middle_name": "RACHAEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ning Sun, FNP-BC
• Nandi Sundaram, PT, MPT
• Levana Sung
• Okbae Sung
• Super Care, LLC (SuperCare Health)
• Suryah Habibi, DMD, Inc
• Sushil Anand & Associates Medical Corp (American Pediatrics Tustin)
• Danielle Swanson
• Robert Jason Sweaza, M.A.
• Robert Leroy Swenson, DDS

• Family Nurse Practitioner in Tustin, CA
• Providers in Tustin, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.