Provider Demographics
NPI:1174680763
Name:GINGERICH, JANE ANN (L,CSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ANN
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:L,CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 FOREST LODGE RD
Mailing Address - Street 2:
Mailing Address - City:PEBBLE BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93953-2634
Mailing Address - Country:US
Mailing Address - Phone:831-649-3900
Mailing Address - Fax:831-642-9755
Practice Address - Street 1:621 FOREST AVE
Practice Address - Street 2:SUITE 3-D
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-4264
Practice Address - Country:US
Practice Address - Phone:831-373-5123
Practice Address - Fax:831-642-9755
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical