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General NPI Number Information
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NPI Number | 1447897368
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Entity Type | Organization
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Legal Business Name | E&S JENSEN INC.
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 20560 N DAVIS RD
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City | LODI
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State | CA
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Zip | 95242-9608
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Country | US
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Telephone | 916-247-6264
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Fax | 209-366-6831
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Provider Business Mailing Address
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Address Line | 9629 RIDGEROCK DR
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City | ELK GROVE
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State | CA
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Zip | 95624-4461
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Country | US
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Telephone | 916-247-6264
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Fax |
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Authorized Official
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Title or Position | CFO/ADMINISTRATOR
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Name | SHERRI LYNN ROSSELL-JENSEN
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Credential |
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Telephone | 916-247-6264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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