Provider Demographics
NPI:1841401775
Name:JEFFRIES, RICK N (LCSW)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:N
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9017 CLARISSA DR.
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662
Mailing Address - Country:US
Mailing Address - Phone:916-984-4800
Mailing Address - Fax:916-984-4334
Practice Address - Street 1:785 ORCHARD DR.
Practice Address - Street 2:STE 100
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:916-984-4800
Practice Address - Fax:916-984-4334
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CALCS90791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist