Provider Demographics
NPI:1245541101
Name:JENSEN, ALESHA JANELLE (OD)
Entity type:Individual
Prefix:DR
First Name:ALESHA
Middle Name:JANELLE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N. PALM AVENUE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2221
Mailing Address - Country:US
Mailing Address - Phone:559-229-7202
Mailing Address - Fax:
Practice Address - Street 1:5151 N PALM AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2211
Practice Address - Country:US
Practice Address - Phone:559-229-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist