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NPI Code Detail

MEDICARE: PATRICIA LYNN JENNINGS LMFT

MEDICARE: PATRICIA LYNN JENNINGS LMFT
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 Therapist32483CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111663234OTHERCACAQH

General Provider Information

NPI Number : 1902952807
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA LYNN JENNINGS LMFT
Provider Business Mailing Address
First Line : 720 WILSHIRE BLVD STE 204
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1737
Country : US
Telephone Number : 424-229-5028
Fax Number : 424-229-5528
Provider Business Practice Location Address
First Line : 720 WILSHIRE BLVD STE 204
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1737
Country : US
Telephone Number : 424-229-5028
Fax Number : 424-229-5528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 05/24/2025

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