Healthcare Provider Details

I. General information

NPI: 1063324820
Provider Name (Legal Business Name): JENNIFER CAROLINE WOLFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N PALM CANYON DR STE 215
PALM SPRINGS CA
92262-5685
US

IV. Provider business mailing address

301 N PALM CANYON DR STE 103-1064
PALM SPRINGS CA
92262-5672
US

V. Phone/Fax

Practice location:
  • Phone: 442-274-0149
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165255
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: