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General NPI Number Information
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NPI Number | 1982214805
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Entity Type | Individual
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Provider Name | JEFFREY DAVID WATKINS ACSW
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Gender | Male
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 4411 E KINGS CANYON
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City | FRESNO
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State | CA
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Zip | 93702-3604
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Country | US
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Telephone | 559-600-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 E. KINGS CANYON
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City | FRESNO
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State | CA
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Zip | 93702-3604
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Country | US
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Telephone | 559-600-0700
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 103148
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License Number State | CA
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