Healthcare Provider Details

I. General information

NPI: 1932432507
Provider Name (Legal Business Name): SEANNA LYNN HERRING-JENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4928 E CLINTON WAY STE 101
FRESNO CA
93727-1526
US

IV. Provider business mailing address

7248 PERLMAN DR
SANGER CA
93657-9066
US

V. Phone/Fax

Practice location:
  • Phone: 559-255-8838
  • Fax: 559-452-8107
Mailing address:
  • Phone: 559-255-8838
  • Fax: 559-452-8107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: