Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | C17821214 | CA |
NPI | 1003260142 |
---|---|
Provider Name | Jennifer Lynn Terreri |
First Address | Sacramento, CA 95838-3249 |
Second Address | Sacramento, CA 95838-3249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2016 |
Last Update Date | 14/04/2016 |