Provider Demographics
NPI:1336922640
Name:JAMARAI, PREETI
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:JAMARAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6943 TAILWIND LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5728
Mailing Address - Country:US
Mailing Address - Phone:909-689-6809
Mailing Address - Fax:
Practice Address - Street 1:6943 TAILWIND LN
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-5728
Practice Address - Country:US
Practice Address - Phone:909-689-6809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026766363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner