Provider Demographics
NPI:1386991933
Name:KAMEL, JENNIFER SCHWINN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SCHWINN
Last Name:KAMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:DAWN
Other - Last Name:SCHWINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1533 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3306
Mailing Address - Country:US
Mailing Address - Phone:310-453-5747
Mailing Address - Fax:
Practice Address - Street 1:1533 EUCLID ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3306
Practice Address - Country:US
Practice Address - Phone:310-453-5747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF70610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist