Provider Demographics
NPI:1376834861
Name:JENKINS, MEGAN A (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 EL CAMINO REAL STE 303
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-5581
Mailing Address - Country:US
Mailing Address - Phone:805-250-6505
Mailing Address - Fax:
Practice Address - Street 1:9700 EL CAMINO REAL STE 303
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5581
Practice Address - Country:US
Practice Address - Phone:805-250-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW301891041C0700X
CALCSW650161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical