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NPI Code Detail

MEDICARE: MS. JENNIFER ANN HALL

MEDICARE: MS. JENNIFER ANN HALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2373H00000XDay Training/Habilitation Specialist
3172V00000XCommunity Health Worker
4172V00000XCommunity Health WorkerCA

General Provider Information

NPI Number : 1073840633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER ANN HALL
Provider Business Mailing Address
First Line : 3433 W SHAW AVE STE 108
Second Line :
City : FRESNO
State : CA
Zip : 93711-3229
Country : US
Telephone Number : 559-558-4051
Fax Number :
Provider Business Practice Location Address
First Line : 496 S BARTON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93702-2985
Country : US
Telephone Number : 559-860-4422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2009
Last Update Date : 12/08/2025

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