Provider Demographics
NPI:1326183286
Name:PALACIO-PIAZZA, JENEA (RN)
Entity Type:Individual
Prefix:
First Name:JENEA
Middle Name:
Last Name:PALACIO-PIAZZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JENEA
Other - Middle Name:
Other - Last Name:PALACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2223 MONTEVIDEO DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4503
Mailing Address - Country:US
Mailing Address - Phone:415-353-5050
Mailing Address - Fax:
Practice Address - Street 1:390 40TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2633
Practice Address - Country:US
Practice Address - Phone:510-613-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95375300163WP0809X
CAVN222246101YM0800X
CA222246164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No164X00000XNursing Service ProvidersLicensed Vocational Nurse