Provider Demographics
NPI:1396167946
Name:NEWBY, JADRIA LIBBY
Entity type:Individual
Prefix:
First Name:JADRIA
Middle Name:LIBBY
Last Name:NEWBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9412 BIG HORN BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1101
Mailing Address - Country:US
Mailing Address - Phone:916-609-5100
Mailing Address - Fax:916-609-5160
Practice Address - Street 1:9412 BIG HORN BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1101
Practice Address - Country:US
Practice Address - Phone:916-609-5100
Practice Address - Fax:916-609-5160
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist