Provider Demographics
NPI:1427453190
Name:BARRETTA, JANET KENNEDY
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:KENNEDY
Last Name:BARRETTA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:JORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:210 SOUTH SIERRA SUITE 209 SERENITY HEART COUNSELING SE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361
Mailing Address - Country:US
Mailing Address - Phone:209-287-9237
Mailing Address - Fax:209-543-1869
Practice Address - Street 1:210 SOUTH SIERRA SUITE 209 SERENITY HEART COUNSELING SE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361
Practice Address - Country:US
Practice Address - Phone:209-287-9237
Practice Address - Fax:209-543-1869
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102808106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist