Most Relevant Information
Provider Data
| NPI Number: | 1003378787 |
| Provider Name: | JENNIFER JOSE |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/02/2019 |
| Last Updated: | 04/26/2023 |
Provider Practice Location
2505 W HAMMER LN
STOCKTON
CA
952092839
Practice Location Phone/Fax
| Phone: | 2099543370 |
| Fax: |
Provider Mailing Location
PO BOX 255228
SACRAMENTO
CA
958655228
Provider Mailing Phone/Fax
| Phone: | 2099543370 |
| Fax: |