Individual
JENNIE DEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC 1
Contact information
Practice address
201 D ST STE S, MARYSVILLE, CA 95901-5958
(305) 650-9605
Mailing address
407 JOSHUA CT, ROSEVILLE, CA 95747-8512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CI31641220
CA
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
09/18/2018
Last updated
12/21/2023
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