Provider Demographics
NPI:1407395940
Name:KENNEY, JANA (MSW)
Entity Type:Individual
Prefix:MISS
First Name:JANA
Middle Name:
Last Name:KENNEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 PROVIDENCE MINE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2945
Mailing Address - Country:US
Mailing Address - Phone:530-277-2046
Mailing Address - Fax:
Practice Address - Street 1:202 PROVIDENCE MINE RD STE 105
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2945
Practice Address - Country:US
Practice Address - Phone:530-277-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1233700716101YA0400X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)