Individual
JEAN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1620 N CARPENTER RD STE D41, MODESTO, CA 95351-1160
(209) 523-3710
Mailing address
1620 N CARPENTER RD STE D41, MODESTO, CA 95351-1160
(209) 523-3710
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/20/2024
Last updated
05/15/2025
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