Basic Information
Provider Information
NPI: 1841844677
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKLIN-COBHAM
FirstName: JENNIFER
MiddleName: NATASHA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FRANKLIN
OtherFirstName: JENNIFER
OtherMiddleName: NATASHA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 100 W WALNUT ST # 375
Address2:  
City: PASADENA
State: CA
PostalCode: 911240001
CountryCode: US
TelephoneNumber: 6263957100
FaxNumber:  
Practice Location
Address1: 100 W WALNUT ST # 375
Address2:  
City: PASADENA
State: CA
PostalCode: 911240001
CountryCode: US
TelephoneNumber: 6263957100
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/30/2019
LastUpdateDate: 07/30/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000X205290CAY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


Home