Provider Demographics
NPI:1154770089
Name:CIUFFREDA, JENAE (CSOM, CBBA)
Entity type:Individual
Prefix:
First Name:JENAE
Middle Name:
Last Name:CIUFFREDA
Suffix:
Gender:F
Credentials:CSOM, CBBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 S HICKORY ST STE 207
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4357
Mailing Address - Country:US
Mailing Address - Phone:760-580-5769
Mailing Address - Fax:760-746-4069
Practice Address - Street 1:240 S HICKORY ST STE 207
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4357
Practice Address - Country:US
Practice Address - Phone:760-580-5769
Practice Address - Fax:760-746-4069
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist