| Doctor Name: | JEFFREY PAUL CENTENO |
| NPI Number: | 1205172848 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | 650182 |
| Business Practice Address: | 7484 Larsen Bay St Eastvale, CA - 928809197 |
| Business Phone Number: | 7148658418 |
| Business Fax Number: | |
| Mailing Address: | 7484 Larsen Bay St, EASTVALE |
| State: | CA |
| Postal Code: | 928809197 |
| Phone Number: | 7148658418 |
| Fax Number: | |
| NPI Enumeration Date: | 01/01/2013 |
| NPI Last Update Date: | 01/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | 650182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |