Healthcare Provider Details

I. General information

NPI: 1245526367
Provider Name (Legal Business Name): JENEE N SALLEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 RAILROAD AVE SUITE B
PITTSBURG CA
94565-5236
US

IV. Provider business mailing address

2185 PACHECO ST
CONCORD CA
94520-2309
US

V. Phone/Fax

Practice location:
  • Phone: 925-439-1237
  • Fax: 925-439-8974
Mailing address:
  • Phone: 925-676-0505
  • Fax: 925-676-2814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP20663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: