| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JENELLE NICOLE DEMEDIO | 1871109355 | 2023-09-13 |
Jenelle Nicole Demedio is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1871109355. Registration indicates Jenelle Nicole Demedio is a provider of services with a specialization in Other Service Providers, Case Manager/Care Coordinator (Case Manager/Care Coordinator, ) (All Other Specialties & Provider Types, ) (Case Manager/Care Coordinator, Other Service Providers) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Miss Jenelle Nicole Demedio |
| Practice Office Address | 3580 WILSHIRE BLVD STE 800 LOS ANGELES, CA US |
| Practice Office Telephone | 2136375000 |
| Mailing Address | 3580 WILSHIRE BLVD STE 800 LOS ANGELES, CA 900102505 US |
| Business Telephone | 2136375000 |
| Code | Practice | License No State |
|---|---|---|
| 171M00000X | Other Service Providers Case Manager/Care Coordinator Case Manager/Care Coordinator All Other Specialties & Provider Types Case Manager/Care Coordinator Other Service Providers | |
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |