MEDICARE: KELLY JENSEN

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1669339487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY JENSEN

Provider Business Mailing Address
First Line	:	6844 ALEXANDRIA PL
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-2498
Country	:	US
Telephone Number	:	209-953-8932
Fax Number	:

Provider Business Practice Location Address
First Line	:	6844 ALEXANDRIA PL
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-2498
Country	:	US
Telephone Number	:	209-953-8932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

Similar Medicare Providers

1174480560 — KRISTIN RUFFONI MS
Practice Location Address:

6844 ALEXANDRIA PL
STOCKTON, CA
95207-2498

Practice Phone: 209-953-8952
Practice Fax:

1295692416 — ANNETTE KNOWLES
Practice Location Address:

6844 ALEXANDRIA PL
STOCKTON, CA
95207-2498

Practice Phone: 209-953-8934
Practice Fax:

1891650065 — ANNELISA BUTCHER PPS
Practice Location Address:

6844 ALEXANDRIA PL
STOCKTON, CA
95207-2498

Practice Phone: 209-953-8932
Practice Fax:

1942167762 — SCOTT JEFFREY DENERO MS
Practice Location Address:

6768 ALEXANDRIA PL
STOCKTON, CA
95207-3407

Practice Phone: 209-953-9559
Practice Fax:

1063921567 — MEGAN EILEEN ADDIEGO-HUTTON
Practice Location Address:

1811 GRAND CANAL BLVD STE 2
STOCKTON, CA
95207-8107

Practice Phone: 925-596-3235
Practice Fax:

1114884954 — KIRSTEN JAVERNICK
Practice Location Address:

2010 W SWAIN RD
STOCKTON, CA
95207-4055

Practice Phone: 209-953-8700
Practice Fax:

Directions to “ KELLY JENSEN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.