Provider Demographics
NPI:1245785419
Name:CHENOWETH, JAMAICA ALYISA (MS, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JAMAICA
Middle Name:ALYISA
Last Name:CHENOWETH
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2198 CAYUGA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4023
Mailing Address - Country:US
Mailing Address - Phone:408-309-0215
Mailing Address - Fax:
Practice Address - Street 1:2198 CAYUGA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-4023
Practice Address - Country:US
Practice Address - Phone:415-859-8299
Practice Address - Fax:415-859-9840
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF83762106H00000X
CA135800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist