Provider Demographics
NPI:1689959173
Name:AREEN, JESSICA ROSE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ROSE
Last Name:AREEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLIVER CT
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6685
Mailing Address - Country:US
Mailing Address - Phone:650-391-8855
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST STE 1219
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2907
Practice Address - Country:US
Practice Address - Phone:415-890-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33141103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical