Provider Demographics
NPI:1861963910
Name:MORALES, JENNIFER D (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:MORALES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-3245
Mailing Address - Country:US
Mailing Address - Phone:661-431-8816
Mailing Address - Fax:
Practice Address - Street 1:1624 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-5512
Practice Address - Country:US
Practice Address - Phone:661-837-6130
Practice Address - Fax:661-837-6139
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA802930163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool