Provider Demographics
NPI:1972370484
Name:FOSTER, JENI L
Entity Type:Individual
Prefix:
First Name:JENI
Middle Name:L
Last Name:FOSTER
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 1:33 PONTE LOREN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0235
Mailing Address - Country:US
Mailing Address - Phone:562-674-8606
Mailing Address - Fax:
Practice Address - Street 1:33 PONTE LOREN
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0235
Practice Address - Country:US
Practice Address - Phone:562-674-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator