Provider Demographics
NPI:1225442775
Name:PARKER, JAIME PENNY ROSE
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:PENNY ROSE
Last Name:PARKER
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 1:109 PARMAC RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2294
Mailing Address - Country:US
Mailing Address - Phone:530-891-2986
Mailing Address - Fax:
Practice Address - Street 1:109 PARMAC RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2294
Practice Address - Country:US
Practice Address - Phone:530-891-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health