Provider Demographics
NPI:1568041408
Name:ARMIJO, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ARMIJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MANNING ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-3425
Mailing Address - Country:US
Mailing Address - Phone:661-431-7370
Mailing Address - Fax:
Practice Address - Street 1:2525 N CHESTER AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-1770
Practice Address - Country:US
Practice Address - Phone:661-868-1842
Practice Address - Fax:661-868-1841
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 171M00000X, 172V00000X
CA11769101YA0400X
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator