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General NPI Number Information
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NPI Number | 1548304751
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Entity Type | Individual
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Provider Name | JENNIFER MONNICH-SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 1114 6TH ST
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City | MODESTO
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State | CA
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Zip | 95354-2203
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Country | US
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Telephone | 209-576-2845
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Fax | 209-576-8842
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Provider Business Mailing Address
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Address Line | 1005 ASHFORD CT
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City | MODESTO
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State | CA
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Zip | 95350-3001
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Country | US
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Telephone | 209-985-6844
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS21357
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License Number State | CA
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