Provider Demographics
NPI:1972093268
Name:MORRISON, JENIFER LYNN (MSMFT)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:LYNN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MSMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E MONTANA ST APT 5
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-1761
Mailing Address - Country:US
Mailing Address - Phone:541-914-2113
Mailing Address - Fax:
Practice Address - Street 1:1215 W WEST COVINA PKWY
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790
Practice Address - Country:US
Practice Address - Phone:626-974-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101349106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist