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General NPI Number Information
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NPI Number | 1891604500
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Entity Type | Individual
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Provider Name | JENNIFER WHITNEY
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Gender | Female
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/07/2026
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Provider Practice Location Address
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Address Line | 3117 BONNIE LN
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City | STOCKTON
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State | CA
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Zip | 95204-3647
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Country | US
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Telephone | 209-483-5797
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Fax |
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Provider Business Mailing Address
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Address Line | 710 N YOSEMITE ST
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City | STOCKTON
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State | CA
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Zip | 95203-2733
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Country | US
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Telephone | 209-483-9918
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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 | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 7034063740
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License Number State | CA
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