Individual
DR. JENNIFER J EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10271 FAIRWAY DR, SUITE 100, ROSEVILLE, CA 95678-3540
(916) 786-2020
Mailing address
10271 FAIRWAY DR, SUITE 100, ROSEVILLE, CA 95678-3540
(916) 786-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12400T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12501674
CAQH
CA
Enumeration date
03/11/2013
Last updated
09/17/2013
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