Provider Demographics
NPI:1083120067
Name:JENNINGS, SARA ELIZABETH (NP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ELIZABETH
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:NEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2824 N BOISE ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8765
Mailing Address - Country:US
Mailing Address - Phone:209-206-1984
Mailing Address - Fax:
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily