Provider Demographics
NPI:1033500533
Name:OQUENDO, JENNIFER (LM, CPM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:OQUENDO
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 HWY 58
Mailing Address - Street 2:
Mailing Address - City:SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:93453-9755
Mailing Address - Country:US
Mailing Address - Phone:805-458-2611
Mailing Address - Fax:
Practice Address - Street 1:8935 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-3923
Practice Address - Country:US
Practice Address - Phone:805-458-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife