Provider Demographics
NPI:1881705341
Name:HIGNELL, PENNISUE MARY (MARRIAGE AND FAMILY)
Entity type:Individual
Prefix:DR
First Name:PENNISUE
Middle Name:MARY
Last Name:HIGNELL
Suffix:
Gender:F
Credentials:MARRIAGE AND FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9255 ESQUON RD # B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CA
Mailing Address - Zip Code:95938-9706
Mailing Address - Country:US
Mailing Address - Phone:530-891-6767
Mailing Address - Fax:530-345-8067
Practice Address - Street 1:9255 ESQUON RD # B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CA
Practice Address - Zip Code:95938-9706
Practice Address - Country:US
Practice Address - Phone:530-891-6767
Practice Address - Fax:530-345-8067
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 32202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist