Provider Demographics
NPI:1790952943
Name:HARRINGTON, JEWETT JACQUES (CNM)
Entity Type:Individual
Prefix:
First Name:JEWETT
Middle Name:JACQUES
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3503
Mailing Address - Country:US
Mailing Address - Phone:213-484-4444
Mailing Address - Fax:213-483-1902
Practice Address - Street 1:2005 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3503
Practice Address - Country:US
Practice Address - Phone:213-484-4444
Practice Address - Fax:213-483-1902
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1027367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife