Healthcare Provider Details
I. General information
NPI: 1982831301
Provider Name (Legal Business Name): JINA JENSEN PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/11/2009
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 VETERANS DR
HARLINGEN TX
78550-8942
US
IV. Provider business mailing address
2601 VETERANS DR
HARLINGEN TX
78550-8942
US
V. Phone/Fax
- Phone: 956-366-4500
- Fax:
- Phone: 956-366-4500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY-3244 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: