MEDICARE: MS. RUTH ANN KENNEY M.A., MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC34461	CA

General Provider Information

NPI Number	:	1326075417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH ANN KENNEY M.A., MFT

Provider Business Mailing Address
First Line	:	2794 BRADSHAW RD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-1338
Country	:	US
Telephone Number	:	916-364-0718
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 GATEWAY OAKS DR
Second Line	:	SUITE 350
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-3661
Country	:	US
Telephone Number	:	916-614-2888
Fax Number	:	916-503-6917

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	03/06/2012

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