Provider Demographics
NPI:1235886052
Name:JENKINS, MARISA E
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:E
Last Name:JENKINS
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 1:699 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2037
Mailing Address - Country:US
Mailing Address - Phone:209-298-5913
Mailing Address - Fax:
Practice Address - Street 1:130 W GABILAN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2762
Practice Address - Country:US
Practice Address - Phone:831-758-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor