Provider Demographics
NPI:1801095278
Name:RAY, JENNIFER M (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2830 I ST
Mailing Address - Street 2:#304
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-284-7408
Mailing Address - Fax:530-265-0307
Practice Address - Street 1:2830 I ST
Practice Address - Street 2:#304
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-284-7408
Practice Address - Fax:530-265-0307
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17108103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist