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General NPI Number Information
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NPI Number | 1073149993
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Entity Type | Organization
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Legal Business Name | JENNIFER A MITZEL
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 7755 CENTER AVE STE 1100
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3091
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Country | US
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Telephone | 562-413-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 7755 CENTER AVE STE 1100
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3091
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Country | US
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Telephone | 562-413-0400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MITZEL
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Credential | LMFT
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Telephone | 562-413-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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