Provider Demographics
NPI:1427865542
Name:DUNN, JENNIFER (AMFT#133588)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:AMFT#133588
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 PANAMA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-5519
Mailing Address - Country:US
Mailing Address - Phone:510-260-4330
Mailing Address - Fax:
Practice Address - Street 1:5725 PANAMA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-5519
Practice Address - Country:US
Practice Address - Phone:510-260-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA133588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist