STEPHANIE D JENNICHES (NP) – Nurse Practitioner, NPI 1114940988
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for STEPHANIE D JENNICHES (NP)
Woodland Hills Post Office, Oxnard Street, Warner Center, Woodland Hills-Warner Center Neighborhood Council District, Los Angeles, Los Angeles County, California, 91367, United States
WOODLAND HILLS, CA 913654419
Phone: (818) 340-9988
Fax: (818) 587-2493
Type: Mailing
San Antonio Regional Hospital, 999, San Bernardino Road, Upland, San Bernardino County, California, 91786, United States
UPLAND, CA 917864920
Phone: (909) 985-2811
Fax: (818) 587-2493
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-01-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050107000425 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91365)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | CA | |
| Hospitalist, Internal Medicine | CA | |
| - | CA | |
| - | CA | |
| Physician Assistant | CA | |
| - | CA | |
| - | ID | |
| Diagnostic Radiology | CA | |
| - | MD | |
| Orthopedic Surgery | CA |
Reviews
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