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NPI 1114456241

NPI 1114456241 : JENNIFER CAPPELLETTI LMFT 146548 : CORTE MADERA, CA

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General NPI Number Information
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    NPI Number           |    1114456241
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER CAPPELLETTI LMFT 146548
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/12/2017
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    Last Update Date     |    04/28/2025
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Provider Practice Location Address
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    Address Line         |    21 TAMAL VISTA BLVD 
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    City                 |    CORTE MADERA
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    State                |    CA
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    Zip                  |    94925-1130
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    Country              |    US
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    Telephone            |    415-496-6584
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 29 
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    City                 |    BURLINGAME
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    State                |    CA
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    Zip                  |    94011-0029
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    146548
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    License Number State |    CA
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