Active NPI
Jennie Lee Hanson, MA, MFT INTERN
- Marriage & Family Therapist
- Santa Ana, CA
National Provider Identifier
1306997663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 41268
- Practice address
- 3100 S Harbor Blvd
Suite 200
Santa Ana, CA 92704-6823 - Phone
- (714) 966-8656
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 41268 | CA | Primary |
Addresses
Primary practice location
3100 S Harbor Blvd
Suite 200
Santa Ana, CA 92704-6823
Mailing address
18719 Palm St
Fountain Valley, CA 92708-6440
Phone (714) 968-4361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 41268 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306997663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18719 PALM ST",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927086440",
"telephone_number": "714-968-4361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 S HARBOR BLVD",
"address_2": "SUITE 200",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927046823",
"telephone_number": "714-966-8656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "JENNIE",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "MA, MFT INTERN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 41268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.