Provider Demographics
NPI:1891307120
Name:NJIRICH, JAMIE RENAE (MT)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:RENAE
Last Name:NJIRICH
Suffix:
Gender:F
Credentials:MT
Other - Prefix:MRS
Other - First Name:JAMIE
Other - Middle Name:RENAE
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT
Mailing Address - Street 1:2050 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2373
Mailing Address - Country:US
Mailing Address - Phone:530-527-0121
Mailing Address - Fax:530-527-0179
Practice Address - Street 1:2050 MAIN ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2373
Practice Address - Country:US
Practice Address - Phone:530-527-0121
Practice Address - Fax:530-527-0179
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83249225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist