Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A172106 | CA |
N | 208000000X | Pediatrician | D89383 | MD |
NPI | 1740713734 |
---|---|
Provider Name | Jenika Ferretti-Gallon |
First Address | Sacramento, CA 95817-2307 |
Second Address | Sacramento, CA 95817-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2017 |
Last Update Date | 22/11/2021 |