Most Relevant Information
Provider Data
| NPI Number: | 1003310111 |
| Provider Name: | COLLEEN O'CONNOR JENSEN RN, PHN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC1500X |
| Specialty: | Registered Nurse |
| License Number: | 566236 |
Most Important Dates
| Enumeration Date: | 03/22/2018 |
| Last Updated: | 03/22/2018 |
Provider Practice Location
301 N R ST
LOMPOC
CA
934365226
Practice Location Phone/Fax
| Phone: | 8053500130 |
| Fax: | 8057376412 |
Provider Mailing Location
301 N R ST
LOMPOC
CA
934365226
Provider Mailing Phone/Fax
| Phone: | 8053500130 |
| Fax: | 8057376412 |