Provider Demographics
NPI:1689340085
Name:FARQUHAR, JAMIE GENNETTE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:GENNETTE
Last Name:FARQUHAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:GENNETTE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3503
Mailing Address - Country:US
Mailing Address - Phone:916-442-4519
Mailing Address - Fax:
Practice Address - Street 1:500 22ND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3503
Practice Address - Country:US
Practice Address - Phone:916-442-4519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARH0007340821101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)