Provider Demographics
NPI:1487395232
Name:DINIS, JENNI ANN (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:JENNI
Middle Name:ANN
Last Name:DINIS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17532 ROAD 26
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-3015
Mailing Address - Country:US
Mailing Address - Phone:559-232-1225
Mailing Address - Fax:
Practice Address - Street 1:14191 ROAD 28
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-5714
Practice Address - Country:US
Practice Address - Phone:559-613-8832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95217267163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice