Provider Demographics
NPI:1083921803
Name:PARR, JENNIFER MAY
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MAY
Last Name:PARR
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 1:900 5TH AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2959
Mailing Address - Country:US
Mailing Address - Phone:707-326-0667
Mailing Address - Fax:
Practice Address - Street 1:110 MARGUERITE LN
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:CA
Practice Address - Zip Code:95425-4405
Practice Address - Country:US
Practice Address - Phone:707-529-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health