Provider Demographics
NPI:1699192377
Name:ARTAZ, JENNA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:
Last Name:ARTAZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:GALOOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:900 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5853
Mailing Address - Country:US
Mailing Address - Phone:530-273-2244
Mailing Address - Fax:
Practice Address - Street 1:900 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5853
Practice Address - Country:US
Practice Address - Phone:530-273-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78810106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist