Jennifer Lorraine Kollen, BA, MSW

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1201 Shaffer Rd Ste 1a
Santa Cruz, CA 95060-5761

Phone

(831) 247-6510

NPI assigned

Sep 20, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Front St. Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Santa Cruz, CA
  • NPI 1922242734
  NPD
• Encompass Community Services

  • Community/Behavioral Health Agency
  • Watsonville, CA
  • NPI 1497971436
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1114113321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SHAFFER RD STE 1A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605761",
            "telephone_number": "831-247-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SHAFFER RD STE 1A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605761",
            "telephone_number": "831-247-6510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Potrero St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950602741",
            "country_code": "US",
            "telephone_number": "831-247-6510",
            "fax_number": "831-466-9748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLEN",
        "first_name": "JENNIFER",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "BA, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Ann Koerner, LCS
• Russell Koester, L.AC., DIPL. O.M.
• Keren-Happuch Elizabeth Kohath, DO
• Kohut Medical a Professional Corporation
• Stacia Kokoletsos
• Corina Kong
• Roberto M Kong, MD
• Britney Nkechi Konyeaso
• Briana Koome
• Priyah Koren

• Peer Specialist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.