Doctor Name: | JENNIFER BUCZKO |
NPI Number: | 1063899276 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 1919 |
Business Practice Address: | 6147 Sutter Ave Carmichael, CA - 956082738 |
Business Phone Number: | 6264834001 |
Business Fax Number: | |
Mailing Address: | 1306 L St, DAVIS |
State: | CA |
Postal Code: | 956162136 |
Phone Number: | 6264834001 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2015 |
NPI Last Update Date: | 04/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1919 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |