Provider Demographics
NPI:1245933688
Name:DUGGAN, JAEDELEEN FELIZARDO (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:JAEDELEEN
Middle Name:FELIZARDO
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15325 FAIRFIELD RANCH RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-8842
Mailing Address - Country:US
Mailing Address - Phone:909-557-1600
Mailing Address - Fax:
Practice Address - Street 1:15325 FAIRFIELD RANCH RD STE 150
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-8842
Practice Address - Country:US
Practice Address - Phone:909-557-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily