Provider Demographics
NPI:1164857348
Name:DENTON, JENNIFER CAROLINE
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CAROLINE
Last Name:DENTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-2042
Mailing Address - Country:US
Mailing Address - Phone:831-784-2160
Mailing Address - Fax:
Practice Address - Street 1:726 SAN BENITO ST # 724
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-3941
Practice Address - Country:US
Practice Address - Phone:831-840-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31623103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist