Madrid, Jennifer Lisa

Madrid, Jennifer Lisa is an individual health care provider with primary practice located at 2032 Appaloosa Dr , Petaluma CA 94954-4639. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Psychiatric Technician, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Madrid, Jennifer Lisa can be contacted via phone (707) 322-2018.

Contact Information

Primary practice address
2032 Appaloosa Dr Petaluma CA 94954-4639
Phone: (707) 322-2018
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Psychiatric Technician 167G00000X PT34767 California
Behavioral Health & Social Service Providers / Social Worker 104100000X 109962 California

Profile Details

NPI number 1578912481
LBN Legal business name Madrid, Jennifer Lisa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2016
Last updated Dec 19th, 2022 - about 2 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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