Healthcare Provider Details

I. General information

NPI: 1659586634
Provider Name (Legal Business Name): KARLEEN KEHAU HARMONY JAKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLEEN KEHAU HARMONY WATSON

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date: 01/23/2023
Reactivation Date: 03/01/2023

III. Provider practice location address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8850
US

IV. Provider business mailing address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8850
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7478
  • Fax: 530-822-7484
Mailing address:
  • Phone: 530-822-7478
  • Fax: 530-822-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0125871
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF-58871
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 53472
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: