Individual
JENNIFER LUCILLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDCC III-CS
Contact information
Practice address
2550 W CLINTON AVE BLDG A #125, FRESNO, CA 93705-9370
(559) 408-4643
Mailing address
2550 W CLINTON AVE UNIT 134, FRESNO, CA 93705-4209
(559) 408-4492
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
7177
CA
171M00000X
Case Manager/Care Coordinator
7177
CA
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/08/2007
Last updated
06/03/2025
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