Provider Demographics
NPI:1205229804
Name:GARCIA, JENNIFER FRONTELA (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FRONTELA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:FRONTELA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1548 NOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-2005
Mailing Address - Country:US
Mailing Address - Phone:562-419-1020
Mailing Address - Fax:
Practice Address - Street 1:1548 NOB HILL DR
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-2005
Practice Address - Country:US
Practice Address - Phone:562-419-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52357363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant