Provider Demographics
NPI:1336466069
Name:MALONEY, JENNIE OLIVIA (MHAI)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:OLIVIA
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MHAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVE BLDG 400-A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4731
Mailing Address - Country:US
Mailing Address - Phone:916-993-4131
Mailing Address - Fax:916-993-4886
Practice Address - Street 1:650 HOWE AVE BLDG 400-A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4731
Practice Address - Country:US
Practice Address - Phone:916-993-4131
Practice Address - Fax:916-993-4886
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator