Healthcare Provider Details

I. General information

NPI: 1093607996
Provider Name (Legal Business Name): KATIE DANIELLE JIANNETTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8761 N 56TH ST # 292286
TEMPLE TERRACE FL
33617-6274
US

IV. Provider business mailing address

8761 N 56TH ST # 292286
TEMPLE TERRACE FL
33617-6274
US

V. Phone/Fax

Practice location:
  • Phone: 813-528-6238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: