Provider Demographics
NPI:1225328115
Name:REGAN, JESSIE (LMFT)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:REGAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:CILENTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:507 NATOMA ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2523
Mailing Address - Country:US
Mailing Address - Phone:916-850-0984
Mailing Address - Fax:
Practice Address - Street 1:507 NATOMA ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2523
Practice Address - Country:US
Practice Address - Phone:916-850-0984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93741106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist