Provider Demographics
NPI:1144914078
Name:QUINTERO, JENNIFER MONTSERRAT (LVN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MONTSERRAT
Last Name:QUINTERO
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 1:47795 DUNE PALMS RD APT 9237
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4109
Mailing Address - Country:US
Mailing Address - Phone:442-300-1561
Mailing Address - Fax:
Practice Address - Street 1:47795 DUNE PALMS RD APT 9237
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-4109
Practice Address - Country:US
Practice Address - Phone:442-300-1561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA711001164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse