Individual
JEANNETTE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 W OLIVE AVE, FRESNO, CA 93728-2619
(559) 500-1888
Mailing address
1804 W OLIVE AVE, FRESNO, CA 93728-2619
(559) 500-1888
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
07/21/2026
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