Provider Demographics
NPI:1386949030
Name:JENKINS, BRITTANY (LMFT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:JENKINS
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 1:318 S DETROIT ST APT 310
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3583
Mailing Address - Country:US
Mailing Address - Phone:310-356-9547
Mailing Address - Fax:
Practice Address - Street 1:1225 W 190TH ST
Practice Address - Street 2:SUITE 455H
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-4320
Practice Address - Country:US
Practice Address - Phone:310-356-9547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF64870101YM0800X
CALMFT 84731106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health