Healthcare Provider Details

I. General information

NPI: 1467066886
Provider Name (Legal Business Name): JENNIFER BROWN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 THE ALAMEDA
SAN JOSE CA
95126-1733
US

IV. Provider business mailing address

3200 MOTOR AVE
LOS ANGELES CA
90034-3740
US

V. Phone/Fax

Practice location:
  • Phone: 408-928-1700
  • Fax:
Mailing address:
  • Phone: 310-836-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: