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General NPI Number Information
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NPI Number | 1164980744
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Entity Type | Organization
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Legal Business Name | J&P SPINE CENTER INC.
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1332 W HERNDON AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93711-7118
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Country | US
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Telephone | 559-538-3145
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 E GREEN SAGE AVE
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City | FRESNO
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State | CA
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Zip | 93730-8863
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Country | US
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Telephone | 682-433-9287
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | GINGER JOHNSON
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Credential |
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Telephone | 818-294-2657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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