MEDICARE: JEARENNA ELIZABETH MCNEIL LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	101357	CA
2	104100000X	Social Worker	LCSW101357	CA

General Provider Information

NPI Number	:	1083094387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEARENNA ELIZABETH MCNEIL LCSW

Provider Business Mailing Address
First Line	:	15750 FOOTHILL BLVD
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94578-1012
Country	:	US
Telephone Number	:	408-688-6782
Fax Number	:	408-871-4903

Provider Business Practice Location Address
First Line	:	15750 FOOTHILL BLVD
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94578-1012
Country	:	US
Telephone Number	:	408-688-6782
Fax Number	:	408-871-4903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	02/25/2026

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