Healthcare Provider Details

I. General information

NPI: 1942560388
Provider Name (Legal Business Name): ARIC JENSEN, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 VICENTE ST
SAN FRANCISCO CA
94127-1301
US

IV. Provider business mailing address

35 VICENTE ST
SAN FRANCISCO CA
94127-1301
US

V. Phone/Fax

Practice location:
  • Phone: 415-637-6681
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPSY24535
License Number StateCA

VIII. Authorized Official

Name: DR. ARIC JENSEN
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 415-637-6681