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NPI Code Detail

MEDICARE: MS. JENNIFER I. DOUGHERTY L.C.S.W.

MEDICARE: MS. JENNIFER I. DOUGHERTY L.C.S.W.
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
11041C0700XClinical Social WorkerLCS 18078CA

General Provider Information

NPI Number : 1528191020
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER I. DOUGHERTY L.C.S.W.
Provider Business Mailing Address
First Line : 1911 WILLIAMS DR STE 200
Second Line :
City : OXNARD
State : CA
Zip : 93036-0673
Country : US
Telephone Number : 805-575-7261
Fax Number :
Provider Business Practice Location Address
First Line : 1911 WILLIAMS DR STE 200
Second Line :
City : OXNARD
State : CA
Zip : 93036-0673
Country : US
Telephone Number : 805-575-7261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 05/20/2021

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Directions to “ MS. JENNIFER I. DOUGHERTY L.C.S.W.” Practice Location

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