Jennifer Anderson
Individual provider Active NPI Marriage & Family Therapist · Yucca Valley, CA
NPI 1669606703 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1669606703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 66838 (CA)
- Practice address
- 58471 29 Palms Hwy Ste 102
Yucca Valley, CA 92284-5818 - Phone
- (760) 853-4888
- NPI assigned
- May 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66838 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Star Behavioral Health, Inc. | Past | Accepting new patients | |
| Valley Star Behavioral Health, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CA | ||
| Marriage & Family Therapist | 106H00000X | 66838 | CA | Yes |
Addresses
Primary practice location
58471 29 Palms Hwy Ste 102
Yucca Valley, CA 92284-5818
Mailing address
58471 29 Palms Hwy Ste 102
Yucca Valley, CA 92284-5818
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 174400000X | Other | CA | OTHER |
Other providers in Yucca Valley, CA
- Danielle Amos
- Barbara G. Andersen
- Chrystelle H Anderson
- Cyndi C Anderson
- James D. Anderson
- Angelic Mansions, LLC
- Elena Angioi
- Anil G Indulkar Pharmacist a Professional Corp
- Vicente Javellana Arano
- Archangel Hospice, LLC.
All providers in Yucca Valley, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.