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General NPI Number Information
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NPI Number | 1700215308
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Entity Type | Individual
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Provider Name | JENNIFER BOSS KINSER
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Gender | Female
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 627 13TH ST STE E
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City | MODESTO
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State | CA
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Zip | 95354-2448
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Country | US
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Telephone | 209-753-9944
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 576404
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City | MODESTO
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State | CA
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Zip | 95357-6404
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Country | US
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Telephone | 209-753-9944
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 120812
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 137499
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License Number State | CA
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