Provider Demographics
NPI:1861588717
Name:SABINO, JEFFER Y (FNP)
Entity type:Individual
Prefix:MR
First Name:JEFFER
Middle Name:Y
Last Name:SABINO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 SYMPHONY CT
Mailing Address - Street 2:
Mailing Address - City:HUGHSON
Mailing Address - State:CA
Mailing Address - Zip Code:95326-9143
Mailing Address - Country:US
Mailing Address - Phone:209-883-0833
Mailing Address - Fax:559-386-0550
Practice Address - Street 1:1000 SKYLINE BLVD
Practice Address - Street 2:
Practice Address - City:AVENAL
Practice Address - State:CA
Practice Address - Zip Code:93204-1850
Practice Address - Country:US
Practice Address - Phone:559-386-4500
Practice Address - Fax:559-386-0550
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN231407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMSO712504OtherDEA #
CAR21485Medicare UPIN