Healthcare Provider Details

I. General information

NPI: 1013410885
Provider Name (Legal Business Name): SJET CLINICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2018
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 JENSEN AVE STE 103
SANGER CA
93657-2269
US

IV. Provider business mailing address

418 N. 6TH STREET
FOWLER CA
93625
US

V. Phone/Fax

Practice location:
  • Phone: 559-399-8144
  • Fax: 599-399-8144
Mailing address:
  • Phone: 559-399-8144
  • Fax: 559-834-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21831
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. HECTOR ELPIDIO CABRERA
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 559-399-8144