MEDICARE: ROBYN L JENNINGS ACSW

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	1041C0700X	Clinical Social Worker	LCSW128471	CA

General Provider Information

NPI Number	:	1659071942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN L JENNINGS ACSW

Provider Business Mailing Address
First Line	:	5921 GRANITE HILLS DR N
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-6762
Country	:	US
Telephone Number	:	707-205-7660
Fax Number	:

Provider Business Practice Location Address
First Line	:	5921 GRANITE HILLS DR N
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-6762
Country	:	US
Telephone Number	:	707-205-7660
Fax Number	:

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

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/27/2026

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