Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ASW 34892 | CA |
NPI | 1003215724 |
---|---|
Provider Name | Jenny C Schneider |
First Address | Santa Rosa, CA 95407 |
Second Address | Rohnert Park, CA 94928-3396 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 19/08/2014 |