Provider Demographics
NPI:1548809254
Name:JENKINS, ANGEL (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6846 SILVERTHORNE CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-2644
Mailing Address - Country:US
Mailing Address - Phone:916-296-3987
Mailing Address - Fax:
Practice Address - Street 1:4616 ROSEVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-5161
Practice Address - Country:US
Practice Address - Phone:916-574-2414
Practice Address - Fax:916-574-2201
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical