Provider Demographics
NPI:1508346966
Name:CERNA, JENNEFER GUARDADO
Entity type:Individual
Prefix:
First Name:JENNEFER
Middle Name:GUARDADO
Last Name:CERNA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 GILMA DR
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-2606
Mailing Address - Country:US
Mailing Address - Phone:510-725-7302
Mailing Address - Fax:
Practice Address - Street 1:2903 GILMA DR
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-2606
Practice Address - Country:US
Practice Address - Phone:510-725-7302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153762106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist