Provider Demographics
NPI:1932235413
Name:WILSON, JEANNETTE CHRISTINE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:CHRISTINE
Last Name:WILSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:JEANNETTE
Other - Middle Name:CHRISTINE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 221534
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-8534
Mailing Address - Country:US
Mailing Address - Phone:916-519-8977
Mailing Address - Fax:
Practice Address - Street 1:2308 J ST STE D
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4718
Practice Address - Country:US
Practice Address - Phone:916-572-7236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor