MEDICARE: TRICIA M JENKINS-ROBERTS

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	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1326264169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRICIA M JENKINS-ROBERTS

Provider Business Mailing Address
First Line	:	85 RAMONA EXPY STE 1
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-7014
Country	:	US
Telephone Number	:	951-349-4195
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 RAMONA EXPY STE 1
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-7014
Country	:	US
Telephone Number	:	951-349-4195
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	10/03/2023

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Directions to “ TRICIA M JENKINS-ROBERTS ” Practice Location

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