Jenkins, Connie

Jenkins, Connie is an sole proprietor health care provider with primary practice located at 4510 Peralta Blvd Suite 1, Fremont CA 94536-5755. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Jenkins, Connie can be contacted via phone (510) 713-3202.

Contact Information

Primary practice address
4510 Peralta Blvd Suite 1 Fremont CA 94536-5755
Phone: (510) 713-3202
Fax: (510) 713-0684
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X J0412282011 California

Profile Details

NPI number 1841488004
LBN Legal business name Jenkins, Connie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2007
Last updated Oct 11th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1841488004 NPPES
California Other J0412282011 BREINING INSTITUTE

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