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Jeffensen Jay Timacdog

Nurse Practitioner Nurse Practitioner - Primary Care

2175 Park Pl
El Segundo , California 90245-4705

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Jeffensen Jay Timacdog

Nurse Practitioner Nurse Practitioner - Primary Care

2175 Park Pl
El Segundo , California 90245-4705

Write a Review Save Call

Jeffensen Jay Timacdog

Nurse Practitioner Nurse Practitioner - Primary Care

2175 Park Pl
El Segundo , California 90245-4705

Write a Review Save

About


Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Nurse Practitioner
  • Nurse Practitioner - Primary Care

Languages spoken

  • English

Location

2175 Park Pl El Segundo , California 90245-4705

First Address

  • Jeffensen Jay Timacdog
  • 1196 3rd Ave
  • Chula Vista, CA
  • Zip : 91911-3131
  • Phone :

Second Address

  • Jeffensen Jay Timacdog
  • 2175 Park Pl
  • El Segundo, CA
  • Zip : 90245-4705
  • Phone : (818) 337-8701

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FAQs


Where did Jeffensen Jay Timacdog attend graduate school?

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Where did Jeffensen Jay Timacdog do his residency?

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Where did Jeffensen Jay Timacdog do his fellowship?

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Is Jeffensen Jay Timacdog board certified?

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What type of doctor is Jeffensen Jay Timacdog

Nurse Practitioner - Primary Care

In what state does Jeffensen Jay Timacdog practice in?

California

Where is Jeffensen Jay Timacdog ’s practice located?

2175 Park Pl , El Segundo, California, 90245-4705

What is Jeffensen Jay Timacdog ’s gender?

Male

Is Jeffensen Jay Timacdog a sole practitioner?

No

Is Jeffensen Jay Timacdog accepting new patients?

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What languages does Jeffensen Jay Timacdog speak?

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Does Jeffensen Jay Timacdog accept insurance?

Yes, Jeffensen Jay Timacdog accepts insurance

Does Jeffensen Jay Timacdog offers telemedicine?

Jeffensen Jay Timacdog has not indicated if he offers telemedicine

What is Jeffensen Jay Timacdog ’s professional license number?

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What is Jeffensen Jay Timacdog ’s NPI number?

1083103956

Does Jeffensen Jay Timacdog have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
N 363L00000X Nurse Practitioner 95008823 CA
Y 363LP2300X Nurse Practitioner - Primary Care NP95008823 CA

National Provider Identifier

NPI 1083103956
Provider Name Jeffensen Jay Timacdog
First Address Chula Vista, CA 91911-3131
Second Address El Segundo, CA 90245-4705
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 07/05/2018
Last Update Date 24/02/2021

NPI Footnotes


What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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