Healthcare Provider Details

I. General information

NPI: 1073010278
Provider Name (Legal Business Name): JENNIFER ANN LAFLEUR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 E AVENIDA DE LOS ARBOLES STE B
THOUSAND OAKS CA
91360-7611
US

IV. Provider business mailing address

365 E AVENIDA DE LOS ARBOLES STE B 1972
THOUSAND OAKS CA
91360-7611
US

V. Phone/Fax

Practice location:
  • Phone: 818-308-4845
  • Fax:
Mailing address:
  • Phone: 818-308-4845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number113577
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number127937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: