Provider Demographics
NPI:1639472368
Name:CAPUCAO, JENNIE PASCUAL (RN)
Entity Type:Individual
Prefix:MS
First Name:JENNIE
Middle Name:PASCUAL
Last Name:CAPUCAO
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:11401 WAKEHURST CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9355
Mailing Address - Country:US
Mailing Address - Phone:661-868-0221
Mailing Address - Fax:661-868-0265
Practice Address - Street 1:1800 MOUNT VERNON AVE
Practice Address - Street 2:CALIFORNIA CHILDREN'S SERVICES 2ND FLOOR
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-0221
Practice Address - Fax:661-868-0265
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA480168163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse