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1003004474
JENNIFER RUTH PETTIBONE
FAIRFIELD, CA
NPI
1003004474
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 464317)
Enumeration Date
2007-10-10
Last Update Date
2007-10-10
Business Address
Ms. JENNIFER RUTH PETTIBONE RN
2101 COURAGE DR MS-10-200
FAIRFIELD, CA 94533-6717
Phone number: 707-784-2154
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Mailing Address
Ms. JENNIFER RUTH PETTIBONE RN
1048 2ND ST APT 6
NOVATO, CA 94945-2439
Phone number: 415-897-1899
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