Provider Demographics
NPI:1386942175
Name:EUGENIO, JENNIFER MIGUEL (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MIGUEL
Last Name:EUGENIO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 CALLE DE PRIMAVERA
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-1438
Mailing Address - Country:US
Mailing Address - Phone:408-988-6382
Mailing Address - Fax:
Practice Address - Street 1:5 COLTON CT
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-4042
Practice Address - Country:US
Practice Address - Phone:650-366-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645049163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse