Provider Demographics
NPI:1386477115
Name:DYKHENG, JEE JEAN TOLENTINO (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JEE JEAN
Middle Name:TOLENTINO
Last Name:DYKHENG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4134 GOLDEN FLEECE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-9107
Mailing Address - Country:US
Mailing Address - Phone:818-216-0761
Mailing Address - Fax:818-216-0761
Practice Address - Street 1:20260 MOBILE ST
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-4241
Practice Address - Country:US
Practice Address - Phone:818-216-0761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032051363LF0000X
NV830158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily