Provider Demographics
NPI:1174419014
Name:JAEN, EMILY K (BSN, FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:JAEN
Suffix:
Gender:F
Credentials:BSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 VAQUERO GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1647
Mailing Address - Country:US
Mailing Address - Phone:858-471-6342
Mailing Address - Fax:
Practice Address - Street 1:8778 CUYAMACA ST
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4255
Practice Address - Country:US
Practice Address - Phone:619-449-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA675884163W00000X
CAF03250020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse