Provider Demographics
NPI:1013040260
Name:ROSSETH, JANE ANN (MFT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:ROSSETH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 N FREEWAY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1954
Mailing Address - Country:US
Mailing Address - Phone:916-576-7900
Mailing Address - Fax:
Practice Address - Street 1:401 PROVIDENCE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2203
Practice Address - Country:US
Practice Address - Phone:855-501-1004
Practice Address - Fax:855-436-1241
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44318106H00000X
NC1504106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist