Provider Demographics
NPI:1811158413
Name:SAENZ, JEANNETTE MONIQUE (MA, CATC IV 23382)
Entity type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:MONIQUE
Last Name:SAENZ
Suffix:
Gender:F
Credentials:MA, CATC IV 23382
Other - Prefix:
Other - First Name:JEANNETTE
Other - Middle Name:MONIQUE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, CATC IV 23382
Mailing Address - Street 1:2180 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:SN LUIS OBISP
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4558
Mailing Address - Country:US
Mailing Address - Phone:805-788-8743
Mailing Address - Fax:
Practice Address - Street 1:2180 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:SN LUIS OBISP
Practice Address - State:CA
Practice Address - Zip Code:93401-4558
Practice Address - Country:US
Practice Address - Phone:805-788-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23382101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)