Provider Demographics
NPI:1144045923
Name:RICHTER, JENNIFER SAMANTHA (LCSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SAMANTHA
Last Name:RICHTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12546 SUNNYGLEN DR
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2778
Mailing Address - Country:US
Mailing Address - Phone:818-825-6244
Mailing Address - Fax:
Practice Address - Street 1:12546 SUNNYGLEN DR
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2778
Practice Address - Country:US
Practice Address - Phone:818-825-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2880821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical