Individual
JENNIE SIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4879 E KINGS CANYON RD, FRESNO, CA 93727-3811
(559) 255-8395
Mailing address
349 S BLOSSER AVE, FRESNO, CA 93706-2242
(559) 375-6093
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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