Provider Demographics
NPI:1053155200
Name:TAPIA, JADE SENNETT
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:SENNETT
Last Name:TAPIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHURCH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2761
Mailing Address - Country:US
Mailing Address - Phone:347-778-3490
Mailing Address - Fax:
Practice Address - Street 1:50 CHURCH ST STE 105
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2761
Practice Address - Country:US
Practice Address - Phone:347-778-3490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula