Provider Demographics
NPI:1730100231
Name:ROSENFELD, JEAN A (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:A
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 RIVER OAK WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5560
Mailing Address - Country:US
Mailing Address - Phone:916-487-8276
Mailing Address - Fax:916-487-8276
Practice Address - Street 1:5730 RIVER OAK WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-5560
Practice Address - Country:US
Practice Address - Phone:916-487-8276
Practice Address - Fax:916-487-8276
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS120561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical