Provider Demographics
NPI:1932190022
Name:SLOCUM, JENNIFER PONTZ (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:PONTZ
Last Name:SLOCUM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:CAROL
Other - Last Name:PONTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2100 CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5721
Mailing Address - Country:US
Mailing Address - Phone:916-442-4985
Mailing Address - Fax:619-442-1029
Practice Address - Street 1:2100 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5721
Practice Address - Country:US
Practice Address - Phone:916-442-4985
Practice Address - Fax:619-442-1029
Is Sole Proprietor?:No
Enumeration Date:2005-10-29
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18847363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner