Healthcare Provider Details

I. General information

NPI: 1720450208
Provider Name (Legal Business Name): JENAYA HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENAYA NORFLEET

II. Dates (important events)

Enumeration Date: 10/23/2015
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W VICTORIA ST
GARDENA CA
90248-3523
US

IV. Provider business mailing address

108 W VICTORIA ST
GARDENA CA
90248-3523
US

V. Phone/Fax

Practice location:
  • Phone: 310-715-2020
  • Fax:
Mailing address:
  • Phone: 310-715-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW81495
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW61509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: