Dina R Jenkins, RDA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1360600819 Issued in CA

Practice address

1001 Sneath LN
San Bruno, CA 94066-2308

Phone

(650) 244-1444

Fax

(650) 244-1447

NPI assigned

Oct 30, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1104170026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SNEATH LN",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662308",
            "telephone_number": "650-244-1444",
            "fax_number": "650-244-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SNEATH LN",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662308",
            "telephone_number": "650-244-1444",
            "fax_number": "650-244-1447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2950 International Blvd",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946012228",
            "country_code": "US",
            "telephone_number": "510-535-4450",
            "fax_number": "510-535-4494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DINA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "RDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "R1360600819",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1360600819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raveena Jagarnauth
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• Stacey Joanna Jeong
• Angelica Jew
• Emma Jimenez Garcia
• Carlos Alberto Jimenez
• Lia Isabella Joachim

• Addiction (Substance Use Disorder) Counselor in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.