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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

JENNIFER R PETTIBONE, RN
2101 COURAGE DR
MS-10-200
FAIRFIELD, CA94533-6717
 Phone: 707-784-2154
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

163WP0808X
Indicates primary specialty

NPI Profile & details for JENNIFER R PETTIBONE · (Female)

NPI Number 1003004474
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 10/10/2007
Last updated 10/10/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 464317
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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