Healthcare Provider Details

I. General information

NPI: 1174034698
Provider Name (Legal Business Name): JENNIFER MARY HAUSER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 EUCLID AVE
SAN DIEGO CA
92105-5424
US

IV. Provider business mailing address

750 B ST STE 2870
SAN DIEGO CA
92101-8132
US

V. Phone/Fax

Practice location:
  • Phone: 619-722-0014
  • Fax: 619-327-4174
Mailing address:
  • Phone: 619-722-0014
  • Fax: 619-327-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: