Kennison, Yajaira Marilyn

Kennison, Yajaira Marilyn is an individual health care provider with primary practice located at 10775 Pioneer Trl Ste 215 , Truckee CA 96161-0234. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kennison, Yajaira Marilyn can be contacted via phone (415) 424-4266.

Contact Information

Primary practice address
10775 Pioneer Trl Ste 215 Truckee CA 96161-0234
Phone: (415) 424-4266
Fax: (415) 520-6633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 31592 Minnesota
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor 225C00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 79259 California

Profile Details

NPI number 1700031648
LBN Legal business name Kennison, Yajaira Marilyn
Credentials PSYD, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2008
Last updated Apr 28th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700031648 NPPES
California MEDICAID 1700031648

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