Provider Demographics
NPI:1801829536
Name:RANKIN, JEFFREY MOUNT (DMH)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MOUNT
Last Name:RANKIN
Suffix:
Gender:M
Credentials:DMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3093 CITRUS CIR # 170
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2687
Mailing Address - Country:US
Mailing Address - Phone:925-687-5260
Mailing Address - Fax:530-661-1666
Practice Address - Street 1:3093 CITRUS CIR # 170
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2687
Practice Address - Country:US
Practice Address - Phone:925-687-5260
Practice Address - Fax:530-661-1666
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10772103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist