Healthcare Provider Details

I. General information

NPI: 1801728639
Provider Name (Legal Business Name): JENNA MARIE BIANCHI MS, ED SP, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 SANTIAGO ST UNIT A
SAN FRANCISCO CA
94116-1526
US

IV. Provider business mailing address

1330 GUERRERO ST UNIT A
SAN FRANCISCO CA
94110-3623
US

V. Phone/Fax

Practice location:
  • Phone: 415-325-2018
  • Fax:
Mailing address:
  • Phone: 209-304-7543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number220176013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: