Provider Demographics
NPI:1447850367
Name:HUYNH, JENNY MARIE (NP)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:MARIE
Last Name:HUYNH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:MARIE
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1100 MAGELLAN DR
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-1380
Mailing Address - Country:US
Mailing Address - Phone:661-823-3000
Mailing Address - Fax:
Practice Address - Street 1:1100 MAGELLAN DR
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-1380
Practice Address - Country:US
Practice Address - Phone:661-823-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021189363L00000X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program