Healthcare Provider Details

I. General information

NPI: 1316728538
Provider Name (Legal Business Name): JENNIFER LYNN SPEER RRT, ACCS, CPFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4785 N 1ST ST STE 103
FRESNO CA
93726-0513
US

IV. Provider business mailing address

4785 N 1ST ST STE 103
FRESNO CA
93726-0513
US

V. Phone/Fax

Practice location:
  • Phone: 559-448-2303
  • Fax:
Mailing address:
  • Phone: 559-448-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number26558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: