Provider Demographics
NPI:1841030731
Name:ATTENBOROUGH, JENNA MARY-YUE
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARY-YUE
Last Name:ATTENBOROUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YUE
Other - Middle Name:
Other - Last Name:ATTENBOROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 W CENTER ST STE 12A&14
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-7300
Mailing Address - Country:US
Mailing Address - Phone:209-239-9600
Mailing Address - Fax:
Practice Address - Street 1:955 W CENTER ST STE 12A&14
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-7300
Practice Address - Country:US
Practice Address - Phone:209-239-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)