Jennifer Lynn Pena, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

NPF 12752 Issued in CA

Practice address

9220 W Sunset Blvd
Suite 110
Los Angeles, CA 90069-3501

Phone

(310) 248-4010

Fax

(310) 248-4001

NPI assigned

Aug 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1962759878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 W SUNSET BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900693500",
            "telephone_number": "310-248-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 W SUNSET BLVD",
            "address_2": "SUITE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900693501",
            "telephone_number": "310-248-4010",
            "fax_number": "310-248-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "RN525621",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NPF 12752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1902846306",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "W18762",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDI-CAL",
            "identifier": "GR0100430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gilberto Pena
• Isabella Pena
• Ivane Joelle Pena
• Janet Pena
• Jennifer Pena
• Johana Yesenia Pena
• Kimberly C Pena
• Laura Socorro Pena, DC
• Macrina B. Pena, NONE
• Maggie Pena

• Acute Care Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.