Provider Demographics
NPI:1841057692
Name:JAVIER, JINKEE MARIE LUNAR (NP)
Entity type:Individual
Prefix:
First Name:JINKEE MARIE
Middle Name:LUNAR
Last Name:JAVIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 AMERICANA WAY UNIT 229
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91210-1538
Mailing Address - Country:US
Mailing Address - Phone:747-257-5998
Mailing Address - Fax:
Practice Address - Street 1:833 AMERICANA WAY UNIT 229
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91210-1538
Practice Address - Country:US
Practice Address - Phone:747-257-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF02240681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner