Provider Demographics
NPI:1316456833
Name:GOEHRING, JENNIFER ROSE (MFTI, PCCI)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:GOEHRING
Suffix:
Gender:F
Credentials:MFTI, PCCI
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ROSE
Other - Last Name:SHUFELBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1310 CONTINENTAL STREET
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-410-2402
Mailing Address - Fax:530-276-0438
Practice Address - Street 1:1310 CONTINENTAL STREET
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-410-2402
Practice Address - Fax:530-276-0438
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4309101YP2500X
CA101673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional