Healthcare Provider Details

I. General information

NPI: 1154755080
Provider Name (Legal Business Name): JENNIFER P HARRISON MPH, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

5960 S LAND PARK DR # 1370
SACRAMENTO CA
95822-3313
US

V. Phone/Fax

Practice location:
  • Phone: 916-843-9325
  • Fax:
Mailing address:
  • Phone: 916-884-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW91116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: