Provider Demographics
NPI:1104080647
Name:PINA, JERRI (RN)
Entity type:Individual
Prefix:MS
First Name:JERRI
Middle Name:
Last Name:PINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JERRI
Other - Middle Name:
Other - Last Name:ESTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1801 RAMBOUILLET RD
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4804
Mailing Address - Country:US
Mailing Address - Phone:805-239-9679
Mailing Address - Fax:
Practice Address - Street 1:2178 JOHNSON AVE.
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4535
Practice Address - Country:US
Practice Address - Phone:805-781-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA592249163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse