Provider Demographics
NPI:1154893410
Name:ANSPACH, JENNIFER LEA (MSW, ACSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEA
Last Name:ANSPACH
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-3610
Mailing Address - Country:US
Mailing Address - Phone:530-528-0900
Mailing Address - Fax:530-528-9339
Practice Address - Street 1:1805 WALNUT ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3610
Practice Address - Country:US
Practice Address - Phone:530-528-0900
Practice Address - Fax:530-528-9339
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW854931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical