Provider Information for 1992942114
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Mrs. JESSICA L CRINER
Sex: Female
NPI: 1992942114
Last Updated: 2024-02-26
Certification Date: 2023-08-03
Certification Date: 2023-08-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1992942114 | ||||||||||||
| Enumeration Date | 2009-01-09 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 764 P ST STE 23 FRESNO, CA 93721-2744 United States Phone: 559-772-4677 | Fax: | ||||||||||||
| Primary Practice Address | 7111 N FRESNO ST FRESNO, CA 93720-2965 United States Phone: 559-232-2375 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 7080 N MARKS AVE STE 104 | ||||||||||||
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