Healthcare Provider Details

I. General information

NPI: 1255067302
Provider Name (Legal Business Name): JINA NEMMERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 GREAT AMERICA PKWY STE 320
SANTA CLARA CA
95054-1140
US

IV. Provider business mailing address

4856 INNOVATION DR
FORT COLLINS CO
80525-5539
US

V. Phone/Fax

Practice location:
  • Phone: 877-371-5488
  • Fax:
Mailing address:
  • Phone: 970-494-4200
  • Fax: 844-270-1824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0021436
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: