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General NPI Number Information
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NPI Number | 1417586264
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Entity Type | Individual
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Provider Name | JENNIFER ENG LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 5060 SHOREHAM PL STE 330
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City | SAN DIEGO
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State | CA
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Zip | 92122-5976
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Country | US
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Telephone | 909-472-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 3950 MAHAILA AVE APT T14
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City | SAN DIEGO
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State | CA
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Zip | 92122-5728
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Country | US
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Telephone | 909-472-8011
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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 | 567
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 17-147
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 101545
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License Number State | CA
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