Provider Demographics
NPI:1316393705
Name:PATEL, JEEGNA (CCP)
Entity Type:Individual
Prefix:
First Name:JEEGNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
Other - First Name:JEEGNA
Other - Middle Name:ANKUSHBHAI
Other - Last Name:CHAUDHARI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2046 MESA AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-7511
Mailing Address - Country:US
Mailing Address - Phone:559-903-9563
Mailing Address - Fax:
Practice Address - Street 1:2046 MESA AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-7511
Practice Address - Country:US
Practice Address - Phone:559-903-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist