Provider Demographics
NPI:1336272814
Name:JENSEN, DANNA ANN (CADC-II CA)
Entity Type:Individual
Prefix:MRS
First Name:DANNA
Middle Name:ANN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:CADC-II CA
Other - Prefix:MISS
Other - First Name:DANNA
Other - Middle Name:ANN
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2087
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-0087
Mailing Address - Country:US
Mailing Address - Phone:209-381-6800
Mailing Address - Fax:209-723-6220
Practice Address - Street 1:301 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6211
Practice Address - Country:US
Practice Address - Phone:209-381-6800
Practice Address - Fax:209-723-6220
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAII8211214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)