Healthcare Provider Details

I. General information

NPI: 1386588101
Provider Name (Legal Business Name): JENKINS SIGNATURE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 MEADOWBROOK LN
RIO VISTA CA
94571-9766
US

IV. Provider business mailing address

673 MEADOWBROOK LN
RIO VISTA CA
94571-9766
US

V. Phone/Fax

Practice location:
  • Phone: 925-727-1439
  • Fax:
Mailing address:
  • Phone: 925-727-1439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: NISHAE S JENKINS
Title or Position: OWNER/ADMINISTRATOR
Credential: ARF ADMINISTRATOR
Phone: 925-727-1439