JENNIFER LYNN RADOMSKI MFTI
NPI 1548637283
Counselor - Mental Health in Santa Rosa, CA
Active since August 28, 2015
About Jennifer Lynn Radomski Mfti NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER LYNN RADOMSKI MFTI (NPI 1548637283) is an individual mental health provider in Santa Rosa, California, licensed in California (MFTI 88480) and active in the NPI registry since August 2015.
NPPES Registry Identity
NPI1548637283
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJENNIFER LYNN RADOMSKICredential: MFTI
Location Address3650 STANDISH AVESanta Rosa, CA 95407-8113
Mailing Address3650 Standish AveSanta Rosa, CA 95407-8113 · (707) 585-6108 · Fax (707) 585-6155
Phone(707) 585-6108
Fax(707) 585-6155
Sole ProprietorNo
Enumeration DateAugust 28, 2015
✔ NPI 1548637283 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CA · MFTI 88480
3650 STANDISH AVE, Santa Rosa, CA 95407
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Student in an Organized Health Care Education/Training Program
3650 STANDISH AVE
SANTA ROSA, CA 95407
SANTA ROSA, CA 95407
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548637283, enumerated as an "individual" on August 28, 2015.
The provider is located at 3650 STANDISH AVE SANTA ROSA, CA 95407 and the phone number is (707) 585-6108.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.