=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306757687
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNA HALES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2026
-----------------------------------------------------
Last Update Date | 09/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1685 WATERTROUGH RD
-----------------------------------------------------
City | SEBASTOPOL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95472-4647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-823-7446
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 193 WEBSTER ST
-----------------------------------------------------
City | PETALUMA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94952-2450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-696-9152
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YS0200X
-----------------------------------------------------
Taxonomy Name | School Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------