Provider Demographics
NPI:1134586050
Name:ALLEN, JENNIFER LYNN (LMFT, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMFT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26485 CARMEL RANCHO BLVD
Mailing Address - Street 2:#5
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8706
Mailing Address - Country:US
Mailing Address - Phone:831-277-9348
Mailing Address - Fax:
Practice Address - Street 1:26485 CARMEL RANCHO BLVD
Practice Address - Street 2:#5
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8706
Practice Address - Country:US
Practice Address - Phone:831-277-9348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
JQP320A79928OtherANTHEM BLUE CROSS