| Doctor Name: | JENNIE MARQUITTA GAINES |
| NPI Number: | 1215250139 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MLT |
| License Number: | 300105 |
| Business Practice Address: | 8760 Redwood Dr Unit 141 Santee, CA - 920717713 |
| Business Phone Number: | 6195924539 |
| Business Fax Number: | |
| Mailing Address: | 8760 Redwood Dr Unit 141, SANTEE |
| State: | CA |
| Postal Code: | 920717713 |
| Phone Number: | 6195924539 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2010 |
| NPI Last Update Date: | 03/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246RM2200X |
| License Number: | 300105 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Pathology |
| Taxonomy Specialization: | Medical Laboratory |
| Taxonomy Definition: | |