Provider Demographics
NPI:1083862296
Name:BILBES, JENNIE C
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:C
Last Name:BILBES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 BEAR RIVER ROW
Mailing Address - Street 2:UNIT #1
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139
Mailing Address - Country:US
Mailing Address - Phone:619-434-5825
Mailing Address - Fax:
Practice Address - Street 1:6860 BEAR RIER ROW
Practice Address - Street 2:UNIT #1
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92139
Practice Address - Country:US
Practice Address - Phone:619-434-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA671157163W00000X, 163WM0102X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient