Healthcare Provider Details

I. General information

NPI: 1578486296
Provider Name (Legal Business Name): JULIE JENNINGS FAMILY THERAPY, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 MAIN ST STE A
MORRO BAY CA
93442-2200
US

IV. Provider business mailing address

645 MAIN ST STE A
MORRO BAY CA
93442-2200
US

V. Phone/Fax

Practice location:
  • Phone: 805-996-0359
  • Fax:
Mailing address:
  • Phone: 805-996-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JULIE JENNINGS
Title or Position: MA, LMFT
Credential: LFMT
Phone: 805-996-0359