Jefferson, Renae

Jefferson, Renae is an individual health care provider with primary practice located at 1800 Tully Rd Ste A2 , Modesto CA 95350-2923. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Jefferson, Renae can be contacted via phone (209) 622-1420.

Contact Information

Primary practice address
1800 Tully Rd Ste A2 Modesto CA 95350-2923
Phone: (209) 622-1420
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Peer Specialist 175T00000X HUAEQGZWBCPYNJDL California

Profile Details

NPI number 1992104590
LBN Legal business name Jefferson, Renae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2014
Last updated Jul 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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