Healthcare Provider Details

I. General information

NPI: 1780917146
Provider Name (Legal Business Name): JENNIFER LEONARD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER LEONARD L.M.F.T.

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N REINO RD # 193
THOUSAND OAKS CA
91320-3710
US

IV. Provider business mailing address

107 N REINO RD # 193
THOUSAND OAKS CA
91320-3710
US

V. Phone/Fax

Practice location:
  • Phone: 805-470-6314
  • Fax:
Mailing address:
  • Phone: 805-470-6314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: