Healthcare Provider Details

I. General information

NPI: 1396639217
Provider Name (Legal Business Name): J&P SPINE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 KINGS COUNTY DR STE 107
HANFORD CA
93230-3579
US

IV. Provider business mailing address

6079 N FRESNO ST STE 101
FRESNO CA
93710-5276
US

V. Phone/Fax

Practice location:
  • Phone: 559-538-3145
  • Fax:
Mailing address:
  • Phone: 818-294-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GINGER JOHNSON
Title or Position: CREDENTIALING
Credential:
Phone: 818-294-2657