Healthcare Provider Details

I. General information

NPI: 1720216427
Provider Name (Legal Business Name): JENNIFER E NASSER LICENSED MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 MISSION ST SUITE 310
SAN FRANCISCO CA
94103-2400
US

IV. Provider business mailing address

2211 POST ST STE 300
SAN FRANCISCO CA
94115-3442
US

V. Phone/Fax

Practice location:
  • Phone: 415-581-0449
  • Fax: 415-581-0458
Mailing address:
  • Phone: 415-429-1952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number80565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: