Healthcare Provider Details

I. General information

NPI: 1609797349
Provider Name (Legal Business Name): RONITA MICHELLE JENKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 HOWE AVE
SACRAMENTO CA
95825-3912
US

IV. Provider business mailing address

855 HOWE AVE
SACRAMENTO CA
95825-3912
US

V. Phone/Fax

Practice location:
  • Phone: 844-664-2248
  • Fax:
Mailing address:
  • Phone: 844-664-2248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95426014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: