Provider Demographics
NPI:1225594088
Name:JAMES, JEANNE LOUISE (MS)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:LOUISE
Last Name:JAMES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28157 RIGGS CT
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94542-2438
Mailing Address - Country:US
Mailing Address - Phone:510-703-3121
Mailing Address - Fax:
Practice Address - Street 1:3180 CROW CANYON PL STE 140
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1339
Practice Address - Country:US
Practice Address - Phone:925-820-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43876106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist