Provider Demographics
NPI:1285142653
Name:QUINTEROS, JEANNETTE (LVN)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:
Last Name:QUINTEROS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 BRIDGE CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-4972
Mailing Address - Country:US
Mailing Address - Phone:918-407-0798
Mailing Address - Fax:
Practice Address - Street 1:1100 4TH ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2415
Practice Address - Country:US
Practice Address - Phone:800-300-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA187120164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse