Individual
JARED JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 N 9TH ST, MODESTO, CA 95350-5814
(209) 525-7412
Mailing address
500 N 9TH ST, MODESTO, CA 95350-5814
(209) 525-7412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/22/2014
Last updated
06/17/2025
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