Provider Demographics
NPI:1083041818
Name:NAWY, JENA
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:NAWY
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:PO BOX 20385
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94820-0385
Mailing Address - Country:US
Mailing Address - Phone:510-847-9254
Mailing Address - Fax:
Practice Address - Street 1:13585 SAN PABLO AVENUE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806
Practice Address - Country:US
Practice Address - Phone:510-942-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-11
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical