Healthcare Provider Details

I. General information

NPI: 1194476259
Provider Name (Legal Business Name): JENNIFER CATHERINE ARIANA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3767 CENTRAL AVE
SAN DIEGO CA
92105-2599
US

IV. Provider business mailing address

7120 SHORELINE DR UNIT 2209
SAN DIEGO CA
92122-4904
US

V. Phone/Fax

Practice location:
  • Phone: 619-584-4010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: