Provider Demographics
NPI:1508429804
Name:JENNER BISHOP INC.
Entity Type:Organization
Organization Name:JENNER BISHOP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNER
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:510-463-4051
Mailing Address - Street 1:2938 WEBSTER ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3407
Mailing Address - Country:US
Mailing Address - Phone:510-463-4051
Mailing Address - Fax:844-848-7556
Practice Address - Street 1:2938 WEBSTER ST STE 200
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3407
Practice Address - Country:US
Practice Address - Phone:510-463-4051
Practice Address - Fax:844-848-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty