Provider Demographics
NPI:1043833734
Name:E&S JENSEN INC.
Entity Type:Organization
Organization Name:E&S JENSEN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSSELL-JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-247-6264
Mailing Address - Street 1:9629 RIDGEROCK DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4461
Mailing Address - Country:US
Mailing Address - Phone:916-247-6264
Mailing Address - Fax:916-478-4036
Practice Address - Street 1:9629 RIDGEROCK DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4461
Practice Address - Country:US
Practice Address - Phone:916-247-6264
Practice Address - Fax:916-478-4036
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities