Individual
ANGELA JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(707) 317-5554
Mailing address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(707) 317-5554
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
86649
CA
104100000X
Social Worker
86649
CA
1041C0700X
Clinical Social Worker
Primary
108105
CA
Other
Enumeration date
07/18/2013
Last updated
05/31/2023
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