Provider Demographics
NPI:1740290204
Name:STERNS, JENNY A C (CPNP, MSN, APRN-RX)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:A C
Last Name:STERNS
Suffix:
Gender:F
Credentials:CPNP, MSN, APRN-RX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 FENTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-3516
Mailing Address - Country:US
Mailing Address - Phone:619-656-3040
Mailing Address - Fax:619-656-3045
Practice Address - Street 1:2440 FENTON ST STE 100
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3516
Practice Address - Country:US
Practice Address - Phone:619-656-3040
Practice Address - Fax:619-656-3045
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1271363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MH409468900Medicaid
MDQ61199Medicare UPIN
MH409468900Medicaid