Provider Demographics
NPI:1558196428
Name:HYNYNEN, JILLIAN (LCSW)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:HYNYNEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 TIARA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5383
Mailing Address - Country:US
Mailing Address - Phone:703-598-8036
Mailing Address - Fax:
Practice Address - Street 1:26431 CROWN VALLEY PKWY STE 260
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-7201
Practice Address - Country:US
Practice Address - Phone:949-237-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1176091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical