Provider Demographics
NPI:1124208756
Name:FERRETTI, JEANNIE ANN (MS, MFTI)
Entity Type:Individual
Prefix:MS
First Name:JEANNIE
Middle Name:ANN
Last Name:FERRETTI
Suffix:
Gender:F
Credentials:MS, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 GUERNEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4053
Mailing Address - Country:US
Mailing Address - Phone:707-577-8058
Mailing Address - Fax:
Practice Address - Street 1:2717 GUERNEVILLE RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4053
Practice Address - Country:US
Practice Address - Phone:707-577-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 54060106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist