Healthcare Provider Details

I. General information

NPI: 1902390164
Provider Name (Legal Business Name): JAIME KATHERINE ZEHNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 LAUREL HILLS DR
SACRAMENTO CA
95841-3105
US

IV. Provider business mailing address

PO BOX 4317
CITRUS HEIGHTS CA
95611-4317
US

V. Phone/Fax

Practice location:
  • Phone: 916-609-5100
  • Fax: 916-609-5160
Mailing address:
  • Phone: 916-215-8990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number79917
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number95565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: