Healthcare Provider Details

I. General information

NPI: 1578391876
Provider Name (Legal Business Name): JENNIFER DE ARMIT MA, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 BUDDY HOLLY DR
STOCKTON CA
95212-2708
US

IV. Provider business mailing address

122 W OAK ST APT 1
LODI CA
95240-3529
US

V. Phone/Fax

Practice location:
  • Phone: 209-953-9298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: