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NPI Code Detail

MEDICARE: JOVEENA PRINCE

MEDICARE: JOVEENA PRINCE
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
11041C0700XClinical Social Worker69013CA

General Provider Information

NPI Number : 1306348479
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOVEENA PRINCE
Provider Business Mailing Address
First Line : 1300 OLIVER RD STE 193
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-3431
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1300 OLIVER RD STE 193
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-3431
Country : US
Telephone Number : 707-514-5812
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2018
Last Update Date : 03/06/2018

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Directions to “ JOVEENA PRINCE ” Practice Location

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