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General NPI Number Information
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NPI Number | 1982192357
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Entity Type | Organization
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Legal Business Name | DRJAYN.COM
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 5661 KEITH AVE STE 104
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City | OAKLAND
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State | CA
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Zip | 94618-1815
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Country | US
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Telephone | 510-516-3188
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Fax |
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Provider Business Mailing Address
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Address Line | 667 LYTTON AVE SUITE 8
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City | PALO ALTO
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State | CA
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Zip | 94301-1335
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Country | US
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Telephone | 510-516-3188
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JAYNTHI JAYN RAJANDRAN
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Credential | PSY D
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Telephone | 510-516-3188
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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 | 50666
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License Number State | CA
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