Provider Demographics
NPI:1740418532
Name:MCFERREN, J'EANNINE MARIE
Entity type:Individual
Prefix:MRS
First Name:J'EANNINE
Middle Name:MARIE
Last Name:MCFERREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:J'EANNINE
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25930 KAY AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-2654
Mailing Address - Country:US
Mailing Address - Phone:510-205-8771
Mailing Address - Fax:
Practice Address - Street 1:545 ESTUDILLO AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4611
Practice Address - Country:US
Practice Address - Phone:510-352-0336
Practice Address - Fax:510-352-8184
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 104100000X
CA151278106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker