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NPI Code Detail

MEDICARE: JENNAH ROSE CHILDS

MEDICARE:   JENNAH ROSE CHILDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLMFT121401CA
2101YM0800XMental Health CounselorMC60539432WA

General Provider Information

NPI Number : 1083078117
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNAH ROSE CHILDS
Provider Business Mailing Address
First Line : 117 E COLORADO BLVD STE 600
Second Line :
City : PASADENA
State : CA
Zip : 91105-3712
Country : US
Telephone Number : 833-225-4673
Fax Number : 408-706-5574
Provider Business Practice Location Address
First Line : 117 E COLORADO BLVD STE 600
Second Line :
City : PASADENA
State : CA
Zip : 91105-3712
Country : US
Telephone Number : 626-318-9732
Fax Number : 408-706-5574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2016
Last Update Date : 12/17/2025

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Directions to “ JENNAH ROSE CHILDS ” Practice Location

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