Provider Demographics
NPI:1982040515
Name:PEROS, JENILYN PALISOC (DNP, FNP-C, MSN)
Entity Type:Individual
Prefix:DR
First Name:JENILYN
Middle Name:PALISOC
Last Name:PEROS
Suffix:
Gender:F
Credentials:DNP, FNP-C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 BALBOA AVE # 302
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5504
Mailing Address - Country:US
Mailing Address - Phone:949-439-0455
Mailing Address - Fax:
Practice Address - Street 1:2204 GARNET AVE STE 209C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3771
Practice Address - Country:US
Practice Address - Phone:949-439-0455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily