Healthcare Provider Details

I. General information

NPI: 1821129735
Provider Name (Legal Business Name): JENNIFER LYNNE HUGHES-MALARA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNNE MALARA LMFT

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 CHELSEA ST
RIDGECREST CA
93555-3208
US

IV. Provider business mailing address

27780 HIALEAH DR
TEHACHAPI CA
93561-5347
US

V. Phone/Fax

Practice location:
  • Phone: 760-463-2880
  • Fax: 760-245-4695
Mailing address:
  • Phone: 661-609-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC46407
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: