Individual provider · Type 1 NPI

Jennifer Ruth Pettibone, RN

Psychiatric/Mental Health Registered Nurse · Fairfield, CA

NPI number 1003004474 Active

Practice location

2101 Courage Dr, MS-10-200
Fairfield, CA 94533-6717

Mailing address

1048 2nd St Apt 6
Novato, CA 94945-2439

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Registered Nurse Primary 163WP0808X464317 (CA)

Psychiatric/Mental Health Registered Nurse: Definition to come...

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About NPI 1003004474

Jennifer Ruth Pettibone, RN's National Provider Identifier is 1003004474, issued on Oct 10, 2007. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Fairfield, CA. The record was last updated on Oct 10, 2007.