JENNA ELIZ TAN DERIVERA CAA NPI 1255123345

NPI Information

  • NPI: 1255123345
  • Provider Name: JENNA ELIZ TAN DERIVERA, CAA
  • Classification: Anesthesiologist Assistant - 367H00000X
  • Entity Type: Individual
  • Address: 1200 PECAN ST SE
    WASHINGTON, DC
    ZIP 20032
  • Phone: (202) 823-4220

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NPI Details

Jenna Eliz Tan Derivera, CAA is an anesthesiologist assistant in Washington, DC with 1 years of experience. The provider is an individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. Jenna Eliz Tan Derivera, CAA NPI is 1255123345. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CASE WESTERN UNIVERSITY SCHOOL OF DENTAL MEDICINE
Graduation Year:2025

The provider's business location address is:

1200 PECAN ST SE
WASHINGTON, DC
ZIP 20032-652
Phone: (202) 823-4220

The enumeration date for this NPI number is 5/22/2025 and was last updated on 5/22/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1367H00000XAnesthesiologist AssistantYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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