Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A152376 | CA |
NPI | 1013332451 |
---|---|
Provider Name | Jennifer Ornelas |
First Address | Sacramento, CA 95815-4517 |
Second Address | Sacramento, CA 95815-4517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2014 |
Last Update Date | 18/08/2021 |