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General NPI Number Information
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NPI Number | 1770695165
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Entity Type | Individual
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Provider Name | JINNIE DEANNE MARTINUSEN MFT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 2627 CAPITOL AVE
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City | SACRAMENTO
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State | CA
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Zip | 95816-5904
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Country | US
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Telephone | 916-838-2236
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Fax | 916-244-0574
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Provider Business Mailing Address
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Address Line | P.O. BOX 188412
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City | SACRAMENTO
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State | CA
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Zip | 95818
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Country | US
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Telephone | 916-838-2236
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Fax | 916-929-2246
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 413808MFTINTERN
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 43514
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License Number State | CA
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