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General NPI Number Information
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NPI Number | 1154650927
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Entity Type | Individual
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Provider Name | JENNIFER MARIE LEAVENS WASHBURN NP
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Gender | Female
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 2519 E WHITMORE AVE
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City | CERES
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State | CA
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Zip | 95307-2634
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Country | US
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Telephone | 209-537-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MEMORY LN
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City | TURLOCK
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State | CA
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Zip | 95382-7272
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Country | US
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Telephone | 209-918-9357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19291
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License Number State | CA
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