Provider Demographics
NPI:1659104982
Name:ORME, JEANETTE DAVIDSONWENDT (MA, MFT)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:DAVIDSONWENDT
Last Name:ORME
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 ALDEN AVE
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-3718
Mailing Address - Country:US
Mailing Address - Phone:707-888-3555
Mailing Address - Fax:
Practice Address - Street 1:146 ALDEN AVE
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-3718
Practice Address - Country:US
Practice Address - Phone:707-888-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA45332101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist