Individual
JESUSA NINA JENIN RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 428-1131
Mailing address
5227 MAYRENE BATES LN, FAIRFIELD, CA 94533-1496
(707) 208-7643
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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