Provider Demographics
NPI:1902644586
Name:BUZZELLI, JEANNI NOBLE (PPS)
Entity type:Individual
Prefix:
First Name:JEANNI
Middle Name:NOBLE
Last Name:BUZZELLI
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-2029
Mailing Address - Country:US
Mailing Address - Phone:559-793-2402
Mailing Address - Fax:
Practice Address - Street 1:600 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-2029
Practice Address - Country:US
Practice Address - Phone:559-793-2402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool