Healthcare Provider Details

I. General information

NPI: 1487393237
Provider Name (Legal Business Name): JENNIFER SOUSA ACEVES AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER SOUSA AMFT

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N K ST
TULARE CA
93274-4003
US

IV. Provider business mailing address

141 N K ST
TULARE CA
93274-4003
US

V. Phone/Fax

Practice location:
  • Phone: 559-366-4494
  • Fax:
Mailing address:
  • Phone: 559-366-4494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: