Healthcare Provider Details

I. General information

NPI: 1245245166
Provider Name (Legal Business Name): JEANNE MARIA TEMPLEMAN RN, CNS, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 CHESTNUT HILL DR
SACRAMENTO CA
95826-2914
US

IV. Provider business mailing address

2725 CHESTNUT HILL DR
SACRAMENTO CA
95826-2914
US

V. Phone/Fax

Practice location:
  • Phone: 916-538-6454
  • Fax: 916-381-5111
Mailing address:
  • Phone: 916-538-6454
  • Fax: 916-381-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number332543
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number208
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: