Healthcare Provider Details

I. General information

NPI: 1952393902
Provider Name (Legal Business Name): JENI-ANN KREN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 POLLASKY AVE SUITE C
CLOVIS CA
93612-1159
US

IV. Provider business mailing address

PO BOX 27763
FRESNO CA
93729-7763
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-6992
  • Fax: 559-297-6992
Mailing address:
  • Phone: 559-297-6992
  • Fax: 559-297-6992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY6711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: