Provider Demographics
NPI:1073791224
Name:MCMACKIN, JENIFFER (LMFT)
Entity type:Individual
Prefix:
First Name:JENIFFER
Middle Name:
Last Name:MCMACKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27601 FORBES RD STE 49
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1242
Mailing Address - Country:US
Mailing Address - Phone:949-403-5006
Mailing Address - Fax:
Practice Address - Street 1:27601 FORBES RD STE 49
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1242
Practice Address - Country:US
Practice Address - Phone:949-403-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA52210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist