Individual
JENNIFER LOUISE LALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NP
Contact information
Practice address
785 MEDICAL CENTER DRIVE WEST, 203, CLOVIS, CA 93611-1324
(559) 387-1900
(559) 387-1950
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
797429
CA
363L00000X
Nurse Practitioner
Primary
23124
CA
363LF0000X
Family Nurse Practitioner
23124
CA
Other
Enumeration date
07/25/2013
Last updated
02/02/2021
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