Jennifer Fallman

Individual provider Active NPI Social Worker · McClellan, CA

NPI 1891968418 · NPPES record last updated Oct 18, 2013

Key facts

NPI
1891968418
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
Practice address
5342 Dudley Blvd
Mail Code 116
McClellan, CA 95652-1012
Phone
(916) 561-7461
Fax
(916) 561-7461
NPI assigned
Apr 3, 2008
Reactivated
Oct 3, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Yes

Addresses

Primary practice location

5342 Dudley Blvd
Mail Code 116
McClellan, CA 95652-1012

Mailing address

5342 Dudley Blvd
Mail Code 116
McClellan, CA 95652-1012
Phone (916) 561-7461

Other providers in McClellan, CA

All providers in McClellan, CA · Social Worker in California

Sources for this page

Verify at the official NPI Registry.