Provider Demographics
NPI:1417550963
Name:SINGLETARY, JINELL
Entity Type:Individual
Prefix:
First Name:JINELL
Middle Name:
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 STEPNEY ST # ST3
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-6560
Mailing Address - Country:US
Mailing Address - Phone:323-836-1403
Mailing Address - Fax:
Practice Address - Street 1:6130 AVALON BLVD UNIT 507
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1633
Practice Address - Country:US
Practice Address - Phone:323-836-1403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist