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NPI Code Detail

MEDICARE: JENNIFER KAYE SUMMERFIELD

MEDICARE: JENNIFER KAYE SUMMERFIELD
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1821471368
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KAYE SUMMERFIELD
Provider Business Mailing Address
First Line : 3539 COLLEGE AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-7032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3539 COLLEGE AVE STE 102
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-7032
Country : US
Telephone Number : 925-766-7222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2015
Last Update Date : 04/09/2019

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Directions to “ JENNIFER KAYE SUMMERFIELD ” Practice Location

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