Provider Demographics
NPI:1679339030
Name:SARAN, JENNA (PSYD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:SARAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 FILMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2939
Mailing Address - Country:US
Mailing Address - Phone:814-807-0861
Mailing Address - Fax:814-807-0863
Practice Address - Street 1:120 E 2ND ST FL 3
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1572
Practice Address - Country:US
Practice Address - Phone:814-877-8013
Practice Address - Fax:814-877-8008
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020078103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical