Basic Information
| Provider Information | |||||||||
| NPI: | 1114548476 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | JENNY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1045 W FOUNTAIN WAY | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937053432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597605337 | ||||||||
| FaxNumber: | 5594575896 | ||||||||
| Practice Location | |||||||||
| Address1: | 1616 W SHAW AVE STE D1 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597605337 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2020 | ||||||||
| LastUpdateDate: | 09/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW89696 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.