Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ifeanyi Jimmy

Individual provider Marriage & Family Therapist · NPI 1679189724

Ifeanyi Jimmy is a Marriage and Family Therapist in Manteca, California. Qualified in 2021, 5 years ago. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2020

Practice location Address checks out

302 Cherry Ln
Manteca, CA 95337-4311
Phone: (530) 893-0758
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 132326 (CA)

Record details

NPI number1679189724
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 23, 2020
Last updated in NPPESJune 16, 2023
Certification dateJune 16, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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