Provider Demographics
NPI:1528342599
Name:ABNEY, JEANETTE (LMFT)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:
Last Name:ABNEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 MISSION AVE STE D
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2852
Mailing Address - Country:US
Mailing Address - Phone:760-722-0672
Mailing Address - Fax:760-722-3418
Practice Address - Street 1:713 MISSION AVE STE D
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-2852
Practice Address - Country:US
Practice Address - Phone:760-722-0672
Practice Address - Fax:760-722-3418
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48551106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist