Provider Demographics
NPI:1760539316
Name:SAMPEDRO, JOCELYN (MSN RNP)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:SAMPEDRO
Suffix:
Gender:F
Credentials:MSN RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8317 DAVIS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4918
Mailing Address - Country:US
Mailing Address - Phone:562-869-1511
Mailing Address - Fax:562-869-0771
Practice Address - Street 1:8317 DAVIS ST
Practice Address - Street 2:SUITE A
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4918
Practice Address - Country:US
Practice Address - Phone:562-869-1511
Practice Address - Fax:562-869-0771
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR401038363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01560Medicare UPIN
CAP00064807Medicare ID - Type UnspecifiedMEDICARE RAILROAD
CAWNP10351BMedicare ID - Type Unspecified
CAWNP10351CMedicare PIN