Healthcare Provider Details

I. General information

NPI: 1669339602
Provider Name (Legal Business Name): JENAVIEVE DONNELLY COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 COLLEGE BLVD STE 102
OCEANSIDE CA
92057-6263
US

IV. Provider business mailing address

369 MOONSTONE BAY DR
OCEANSIDE CA
92057-3426
US

V. Phone/Fax

Practice location:
  • Phone: 858-401-6703
  • Fax:
Mailing address:
  • Phone: 858-401-6703
  • Fax:

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: JENAVIEVE DONNELLY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 858-401-6703