Healthcare Provider Details

I. General information

NPI: 1700708989
Provider Name (Legal Business Name): JOURNEY TO SERENITY A LICENSED CLINICAL SOCIAL WORKER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 CENTRAL BLVD STE 113
BRENTWOOD CA
94513-2360
US

IV. Provider business mailing address

1210 CENTRAL BLVD STE 113
BRENTWOOD CA
94513-2360
US

V. Phone/Fax

Practice location:
  • Phone: 800-484-2797
  • Fax: 800-484-2797
Mailing address:
  • Phone: 800-484-2797
  • Fax: 800-484-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENAIAH L SAUCEDA
Title or Position: OWNER
Credential: LCSW
Phone: 800-484-2797