Provider Demographics
NPI:1790235232
Name:HORROCKS, JENNIFER (RNC, NP, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:HORROCKS
Suffix:
Gender:F
Credentials:RNC, NP, IBCLC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:DOTEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:727 CAMINO MANZANAS
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2203
Mailing Address - Country:US
Mailing Address - Phone:818-395-7749
Mailing Address - Fax:
Practice Address - Street 1:727 CAMINO MANZANAS
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2203
Practice Address - Country:US
Practice Address - Phone:818-395-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA559045163WL0100X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant