Provider Demographics
NPI:1134305782
Name:WINN, JALEAH FARRAH (BA)
Entity Type:Individual
Prefix:MS
First Name:JALEAH
Middle Name:FARRAH
Last Name:WINN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-2623
Mailing Address - Country:US
Mailing Address - Phone:510-750-8810
Mailing Address - Fax:925-484-1075
Practice Address - Street 1:1912 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-2623
Practice Address - Country:US
Practice Address - Phone:510-750-8810
Practice Address - Fax:925-484-1075
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health