Provider Demographics
NPI:1447897368
Name:E&S JENSEN INC.
Entity type:Organization
Organization Name:E&S JENSEN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSSELL-JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-247-6264
Mailing Address - Street 1:9629 RIDGEROCK DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4461
Mailing Address - Country:US
Mailing Address - Phone:916-247-6264
Mailing Address - Fax:
Practice Address - Street 1:20560 N DAVIS RD
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-9608
Practice Address - Country:US
Practice Address - Phone:916-247-6264
Practice Address - Fax:209-366-6831
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE JENSEN HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility