Jeanette May Kennedy-Cecil, IMF91980
Individual provider Active NPI Marriage & Family Therapist · Taft, CA
NPI 1720437528 · NPPES record last updated Jun 13, 2016
Key facts
- NPI
- 1720437528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- IMF91980 (CA)
- Practice address
- 1021 4TH St
Taft, CA 93268-2433 - Phone
- (661) 765-7025
- NPI assigned
- Jun 13, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF91980 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| College Community Services | Past |
Accepting new patients | |
| College Community Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF91980 | CA | Yes |
Addresses
Primary practice location
1021 4TH St
Taft, CA 93268-2433
Mailing address
29325 Kimberlina Rd
Wasco, CA 93280
Phone (661) 758-4029
Other providers in Taft, CA
- Victor L Hudson
- J. Sterling Bryan, D.D.S., P.C.
- Ania Jafaryan
- Markie Caitlin Johnson
- Heather Keith
- Claire Kim
- Alexandra Paige Lainez
- Desiree Jayne Domingo Leal
- Lifecare Homes Inc
- Magenta Lindsay
All providers in Taft, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.