Jennifer L. Detisch Nurse Practitioner
4647 Zion Ave, San Diego, CA 92120-2507


Jennifer L. Detisch is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1730215534. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 1557543048. The primary specialty is NURSE PRACTITIONER. The organization is SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP. The address is 4647 Zion Ave, San Diego, CA 92120-2507. The zip code is 92120.


Jennifer L. Detisch · 4647 Zion Ave, San Diego, CA 92120-2507

Nation Provider ID 1730215534
PAC ID by PECOS 1557543048
Professional Enrollment ID I20110304000066
Last Name DETISCH
First Name JENNIFER
Middle Name L.
Gender F
Medical School Name UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduation Year 2006
Primary Specialty NURSE PRACTITIONER
Primary Specialty SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Phone Number 6195285000
Group Practice PAC ID 6002729175
Number of Group Practice Members 7940
Address 4647 ZION AVE
SAN DIEGO, CA 921202507
Professional accepts Medicare Assignment Y

street_number: 4647
route: Zion Avenue (Zion Ave)
neighborhood, political: Grantville
locality, political: San Diego
admin_level_2, political: San Diego County
admin_level_1, political: California (CA)
country, political: United States (US)
postal_code: 92120
postal_code_suffix: 2507
types : street_address
latitude: 32.7914271
longitude: -117.0951397
latlng: (32.7914271, -117.0951397)


Southern California Permanente Medical Group · Medicare Physician

Name Address Specialty
Jordan Lee 14371 Clark, Bellflower, CA 90706-2901 INTERNAL MEDICINE
Myat Han 3733 San Dimas St, Bakersfield, CA 93301-1407 INTERNAL MEDICINE
Elisa Morinelli 14371 Clark, Bellflower, CA 90706-2901 OPHTHALMOLOGY
Chong Young Parke 14371 Clark, Bellflower, CA 90706-2901 INTERNAL MEDICINE
Jaymica Patel 9961 Sierra Ave, Fontana, CA 92335-6720 PULMONARY DISEASE
Sima Hassani 5601 De Soto Ave, Woodland Hills, CA 91367-6798 INTERNAL MEDICINE
Jay Ferns 10800 Magnolia Ave, Riverside, CA 92505-3043 FAMILY PRACTICE
Michele Turner 13652 Cantara St, Panorama City, CA 91402-5423 FAMILY PRACTICE
Dennis Matejka 1255 W Arrow Hwy, San Dimas, CA 91773-2340 INTERNAL MEDICINE
Kimberly Reece 6041 Cadillac Ave, Los Angeles, CA 90034-1702 FAMILY PRACTICE
Long Nguyen 14371 Clark, Bellflower, CA 90706-2901 FAMILY PRACTICE
Paul Chung 411 N Lakeview Ave, Anaheim, CA 92807-3028 INTERVENTIONAL RADIOLOGY
Manuel Mojica 9961 Sierra Ave, Fontana, CA 92335-6720 INTERNAL MEDICINE
Asha Bisht 14371 Clark, Bellflower, CA 90706-2901 INTERNAL MEDICINE
Ivan Magnaye 9961 Sierra Ave, Fontana, CA 92335-6720 INTERNAL MEDICINE
James Gaudet 4647 Zion Ave, San Diego, CA 92120-2507 PSYCHIATRY
Michael Chan 27300 Iris Ave, Moreno Valley, CA 92555-4802 INTERNAL MEDICINE
Theresa Elaine Mendoza 14371 Clark, Bellflower, CA 90706-2901 PHYSICAL THERAPY
James Hwang 10800 Magnolia Ave, Riverside, CA 92505-3043 FAMILY PRACTICE
Stephanie King 9961 Sierra Ave, Fontana, CA 92335-6720 PHYSICAL THERAPY

Zip 92120 · Nurse Practitioner · Medicare Physician

Name Address Specialty
Diane Lewis 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Joyce Croke 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Bruce Thompson 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Lisa Youngblood 6153 Fairmount Ave, San Diego, CA 92120-3407 NURSE PRACTITIONER
Lisa Mager 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Mona Breid 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Philomena Kaliangara 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Amy Bell 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Cristina Tobon-chung 6655 Alvarado Rd, San Diego, CA 92120-5208 NURSE PRACTITIONER
Carole Harris 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Theodore Scott 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Victoria Swartz 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Marie Naughton 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Juana Mazaira 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Rachel Toman 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Alice Kolodji 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Pamela Velardi 6153 Fairmount Ave, San Diego, CA 92120-3407 NURSE PRACTITIONER
Deborah Beccarelli 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Sarah Briere 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER
Allison Waczek 4647 Zion Ave, San Diego, CA 92120-2507 NURSE PRACTITIONER

Zip 92120 · Medicare Physician

Name Address Specialty
Jaianand Sethee 4647 Zion Ave, San Diego, CA 92120-2507 ANESTHESIOLOGY
Mark Soontornvachrin 4647 Zion Ave, San Diego, CA 92120-2507 OPHTHALMOLOGY
Matthew Perez 4647 Zion Ave, San Diego, CA 92120-2507 PHYSICAL THERAPY
Robert Cunningham 4647 Zion Ave, San Diego, CA 92120-2507 EMERGENCY MEDICINE
Victor Schorn 4647 Zion Ave, San Diego, CA 92120-2507 OTOLARYNGOLOGY
James Morgan 4647 Zion Ave, San Diego, CA 92120-2507 INTERNAL MEDICINE
Arash Kermanshahi 4647 Zion Ave, San Diego, CA 92120-2507 ORTHOPEDIC SURGERY
Anand Patel 4647 Zion Ave, San Diego, CA 92120-2507 INTERNAL MEDICINE
Huyen Nguyen 4647 Zion Ave, San Diego, CA 92120-2507 DERMATOLOGY
Minrong Li 4647 Zion Ave, San Diego, CA 92120-2507 CERTIFIED REGISTERED NURSE ANESTHETIST
David Beverly 4647 Zion Ave, San Diego, CA 92120-2507 OPHTHALMOLOGY
Ejaz Ahmed 4647 Zion Ave, San Diego, CA 92120-2507 INTERNAL MEDICINE
Carla Halacker 4647 Zion Ave, San Diego, CA 92120-2507 ANESTHESIOLOGY
Tamar Weissler 4647 Zion Ave, San Diego, CA 92120-2507 FAMILY PRACTICE
Michael Maine 4647 Zion Ave, San Diego, CA 92120-2507 FAMILY PRACTICE
Justus Kam 4647 Zion Ave, San Diego, CA 92120-2507 PSYCHIATRY
Heidi Philips 4647 Zion Ave, San Diego, CA 92120-2507 CLINICAL SOCIAL WORKER
Hai Nguyen 4647 Zion Ave, San Diego, CA 92120-2507 INTERNAL MEDICINE
Catherine Lozano 4647 Zion Ave, San Diego, CA 92120-2507 PHYSICAL THERAPY
Patrick Ramos 4647 Zion Ave, San Diego, CA 92120-2507 UROLOGY