MEDICARE: JEANA RAE ABADEJOS

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1922434786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANA RAE ABADEJOS

Provider Business Mailing Address
First Line	:	4550 KEARNY VILLA RD STE 118
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1574
Country	:	US
Telephone Number	:	619-928-4843
Fax Number	:

Provider Business Practice Location Address
First Line	:	4550 KEARNY VILLA RD STE 118
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1574
Country	:	US
Telephone Number	:	619-928-4843
Fax Number	:

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

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	06/01/2023

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Directions to “ JEANA RAE ABADEJOS ” Practice Location

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