Provider Demographics
NPI:1043499361
Name:JASTRZEMSKI, KERI
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:JASTRZEMSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:HARDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1393 BAILEY DR.
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5922
Mailing Address - Country:US
Mailing Address - Phone:559-582-4481
Mailing Address - Fax:
Practice Address - Street 1:1393 BAILEY DR.
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5922
Practice Address - Country:US
Practice Address - Phone:559-582-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health