Provider Demographics
NPI:1447640677
Name:CONTRERAS, JENNIFER EVANGELINA (PPS SCHOOL PSYCHOLOG)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:EVANGELINA
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PPS SCHOOL PSYCHOLOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2978
Mailing Address - Country:US
Mailing Address - Phone:559-685-7200
Mailing Address - Fax:
Practice Address - Street 1:815 W GAIL AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-1236
Practice Address - Country:US
Practice Address - Phone:559-467-0294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230156180103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA230156180OtherCTC