Individual
JENNY LYNN TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 E FESLER ST, SANTA MARIA, CA 93454-4404
(805) 781-3535
Mailing address
115 E FESLER ST, SANTA MARIA, CA 93454-4404
(805) 357-5195
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35192
CA
Other
Enumeration date
10/14/2021
Last updated
09/13/2022
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