Provider Demographics
NPI:1033554084
Name:ABRAHAM, JINY THOMAS
Entity Type:Individual
Prefix:MRS
First Name:JINY
Middle Name:THOMAS
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4717 N CEDAR AVE
Mailing Address - Street 2:APT #102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-1005
Mailing Address - Country:US
Mailing Address - Phone:201-888-5413
Mailing Address - Fax:
Practice Address - Street 1:13666 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2538
Practice Address - Country:US
Practice Address - Phone:510-357-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health