Healthcare Provider Details

I. General information

NPI: 1780250282
Provider Name (Legal Business Name): DR. JENNIFER FEE PSYCHOLOGY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 DOVE ST STE 105
NEWPORT BEACH CA
92660-2410
US

IV. Provider business mailing address

1601 DOVE ST STE 105
NEWPORT BEACH CA
92660-2410
US

V. Phone/Fax

Practice location:
  • Phone: 562-760-2743
  • Fax:
Mailing address:
  • Phone: 562-760-2743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER L FEE
Title or Position: OWNER
Credential: PSYD
Phone: 562-760-2743