Healthcare Provider Details

I. General information

NPI: 1003473810
Provider Name (Legal Business Name): JING ZHAO BAER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JING ZHAO LMFT

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 PATRICK HENRY DR BLDG 7
SANTA CLARA CA
95054-1863
US

IV. Provider business mailing address

4701 PATRICK HENRY DR BLDG 7
SANTA CLARA CA
95054-1863
US

V. Phone/Fax

Practice location:
  • Phone: 669-200-9857
  • Fax: 650-706-2998
Mailing address:
  • Phone: 669-200-9857
  • Fax: 650-706-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT135141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: