Provider Demographics
NPI:1851792873
Name:MITCHELL, JEANNETTE (IMF)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 EAST ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0855
Mailing Address - Country:US
Mailing Address - Phone:530-605-1361
Mailing Address - Fax:
Practice Address - Street 1:1304 EAST ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0855
Practice Address - Country:US
Practice Address - Phone:530-605-1361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 71274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health