Provider Demographics
NPI:1780716712
Name:MENARY, JEANNE ELISE (EDD)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:ELISE
Last Name:MENARY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SOUTHWOOD CT.
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563
Mailing Address - Country:US
Mailing Address - Phone:510-845-4656
Mailing Address - Fax:925-253-1275
Practice Address - Street 1:8 SOUTHWOOD CT.
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563
Practice Address - Country:US
Practice Address - Phone:510-845-4656
Practice Address - Fax:925-253-1275
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14095103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL140950Medicare ID - Type Unspecified
CAOPL140950Medicare UPIN