Healthcare Provider Details

I. General information

NPI: 1194844290
Provider Name (Legal Business Name): MISS JAMIE DIANE ENOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W CHRISTOFFERSEN PKWY
TURLOCK CA
95382-9509
US

IV. Provider business mailing address

601 COLORADO AVE
TURLOCK CA
95380-4169
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-8519
  • Fax:
Mailing address:
  • Phone: 209-667-8519
  • Fax: 209-667-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number51823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: