Provider Demographics
NPI:1982033130
Name:JENSEN, JANA (RN)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 ORANGE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2839
Mailing Address - Country:US
Mailing Address - Phone:949-548-4900
Mailing Address - Fax:
Practice Address - Street 1:1831 ORANGE AVE STE B
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2839
Practice Address - Country:US
Practice Address - Phone:949-548-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295969163W00000X, 163WA2000X, 163WC2100X, 163WP0000X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory