Provider Demographics
NPI:1720794936
Name:ALLEN, JAMETRA RENE
Entity Type:Individual
Prefix:MS
First Name:JAMETRA
Middle Name:RENE
Last Name:ALLEN
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 1:1604 E 124TH ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90222-1102
Mailing Address - Country:US
Mailing Address - Phone:213-713-6363
Mailing Address - Fax:
Practice Address - Street 1:1138 E ROSECRANS AVE STE C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3645
Practice Address - Country:US
Practice Address - Phone:213-713-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula