Provider Demographics
NPI:1225177322
Name:PARRISH, JENNIFER L (MD, INC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MD, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:114 MISSION RANCH BLVD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-5137
Mailing Address - Country:US
Mailing Address - Phone:530-894-0500
Mailing Address - Fax:530-345-2532
Practice Address - Street 1:114 MISSION RANCH BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-5137
Practice Address - Country:US
Practice Address - Phone:530-894-0500
Practice Address - Fax:530-345-2532
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45879207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF26858Medicare UPIN