Provider Demographics
NPI:1265730667
Name:SUTTON, JEANNE PERI (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:PERI
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2047
Mailing Address - Country:US
Mailing Address - Phone:410-459-5024
Mailing Address - Fax:
Practice Address - Street 1:405 PRIMROSE RD STE 208
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4091
Practice Address - Country:US
Practice Address - Phone:650-762-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT86044106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist