NPI 1003004474
Jennifer Ruth Pettibone, RN
Practice location
- Address
- 2101 Courage Dr Ms-10-200, Fairfield, CA 94533-6717
- Phone
- (707) 784-2154
- Mailing address
- 1048 2nd St APT 6, Novato, CA 94945-2439
Registered specialties
Psychiatric/Mental Health Registered Nurse
Primary
Registry record
- NPI
- 1003004474
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 10 Oct 2007
- Record last updated
- 10 Oct 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.