Provider Demographics
NPI:1861689937
Name:BERTOLANI, JANE (MA)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:BERTOLANI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7909 WALERGA RD STE 112-180
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-5727
Mailing Address - Country:US
Mailing Address - Phone:916-953-8398
Mailing Address - Fax:
Practice Address - Street 1:1330 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5705
Practice Address - Country:US
Practice Address - Phone:916-953-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51321106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist