Healthcare Provider Details

I. General information

NPI: 1275052862
Provider Name (Legal Business Name): JENNIFER DOROTEA NOLAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32605 TEMECULA PKWY STE 305
TEMECULA CA
92592-6840
US

IV. Provider business mailing address

PO BOX 602060
SAN DIEGO CA
92160-2060
US

V. Phone/Fax

Practice location:
  • Phone: 877-840-6956
  • Fax: 619-383-6701
Mailing address:
  • Phone: 877-840-6956
  • Fax: 619-383-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF96469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: