=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134560428
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JILL MICHELLE BABBITT LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2013
-----------------------------------------------------
Last Update Date | 05/12/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15069 BRECKINRIDGE AVE
-----------------------------------------------------
City | EAST GARRISON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93933-5089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-242-0029
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 504 ESTRELLA DORO APARTMENT 6
-----------------------------------------------------
City | MONTEREY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93940-7609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-277-4869
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 85737
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------