Provider Demographics
NPI:1548803356
Name:PENAREJO, JENICA CHARMAINE AQUINO (NP-C)
Entity type:Individual
Prefix:
First Name:JENICA CHARMAINE
Middle Name:AQUINO
Last Name:PENAREJO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JENICA CHARMAINE
Other - Middle Name:BONUS
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:810 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2208
Practice Address - Country:US
Practice Address - Phone:559-376-2729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily