Basic Information
| Provider Information | |||||||||
| NPI: | 1144306804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATES-JENSEN | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | MAE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 S VINEDO AVE | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911074824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264498208 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16111 PLUMMER ST | ||||||||
| Address2: | (11E) | ||||||||
| City: | SEPULVEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913432036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188959311 | ||||||||
| FaxNumber: | 8188959519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WE0900X | 330295 | CA | X | Nursing Service Providers | Registered Nurse | Enterostomal Therapy | 163WG0600X | 330295 | CA | X | Nursing Service Providers | Registered Nurse | Gerontology | 163WM0705X | 330295 | CA | X | Nursing Service Providers | Registered Nurse | Medical-Surgical | 163WW0000X | 330295 | CA | X | Nursing Service Providers | Registered Nurse | Wound Care |
No ID Information.