Individual
JENNIFER RACHEL PANISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3867 HOWE ST, OAKLAND, CA 94611-5343
(510) 595-5509
Mailing address
3867 HOWE ST, OAKLAND, CA 94611-5343
(510) 595-5509
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
25281
CA
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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