Provider Demographics
NPI:1881129732
Name:JEAN, JENNY (MD)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:JEAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-6005
Mailing Address - Country:US
Mailing Address - Phone:951-360-5265
Mailing Address - Fax:951-360-6276
Practice Address - Street 1:6250 CLAY ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-6005
Practice Address - Country:US
Practice Address - Phone:951-360-5265
Practice Address - Fax:951-360-6276
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172775207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology