Provider Demographics
NPI:1710489802
Name:VENATOR, JENNIFER (CNS, RNFA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:VENATOR
Suffix:
Gender:F
Credentials:CNS, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 E VISTA DEL PLAYA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-3438
Mailing Address - Country:US
Mailing Address - Phone:714-856-9730
Mailing Address - Fax:
Practice Address - Street 1:101 E VALENCIA MESA DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3809
Practice Address - Country:US
Practice Address - Phone:714-856-9730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA653887163WR0006X
CA4651364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant