Provider Demographics
NPI:1962984351
Name:SHIRRON, JENNIFER DAWN (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:DAWN
Last Name:SHIRRON
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4100
Mailing Address - Country:US
Mailing Address - Phone:209-953-8354
Mailing Address - Fax:
Practice Address - Street 1:10555 THORNTON RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4100
Practice Address - Country:US
Practice Address - Phone:209-953-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool