Healthcare Provider Details

I. General information

NPI: 1942028295
Provider Name (Legal Business Name): DR. SARA JAMAL JABER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2127 HERNDON AVE STE 103
CLOVIS CA
93611-6303
US

IV. Provider business mailing address

3060 MORRIS AVE
CLOVIS CA
93619-6904
US

V. Phone/Fax

Practice location:
  • Phone: 559-900-4009
  • Fax:
Mailing address:
  • Phone: 708-691-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number110840
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: