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NPI Code Detail

MEDICARE: MISS JANA KENNEY MSW

MEDICARE: MISS JANA KENNEY MSW
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
1101YA0400XAddiction (Substance Use Disorder) CounselorR1233700716CA
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1407395940
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JANA KENNEY MSW
Provider Business Mailing Address
First Line : 202 PROVIDENCE MINE RD STE 105
Second Line :
City : NEVADA CITY
State : CA
Zip : 95959-2945
Country : US
Telephone Number : 530-277-2046
Fax Number :
Provider Business Practice Location Address
First Line : 202 PROVIDENCE MINE RD STE 105
Second Line :
City : NEVADA CITY
State : CA
Zip : 95959-2945
Country : US
Telephone Number : 530-277-2046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2017
Last Update Date : 11/15/2023

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