Jennifer Marie Kennalley
Technician, Other in Stockton, CA. Individual provider (NPI-1).
NPI number1982247565
StatusActive
Last updated in NPPESOct 25, 2019
Details
- NPI
- 1982247565
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Marie Kennalley
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 25, 2019
- Last updated
- Oct 25, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
2291 W March LnStockton, CA 95207-6652
Phone 925-408-8911
Mailing address
2291 W March LnStockton, CA 95207-6652
Phone 925-408-8911
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