Individual
MS. JENNIFER M GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1630 E HERNDON AVE, FRESNO, CA 93720-3391
(559) 256-5200
(559) 256-5376
Mailing address
1630 E HERNDON AVE, FRESNO, CA 93720-3391
(559) 256-5200
(559) 256-5376
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17787
CA
Other
Enumeration date
10/12/2006
Last updated
07/02/2012
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