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General NPI Number Information
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NPI Number | 1548945884
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Entity Type | Individual
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Provider Name | JENNIFER LEE PAGE MS, APCC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 41690 IVY ST STE D5
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City | MURRIETA
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State | CA
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Zip | 92562-9436
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Country | US
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Telephone | 951-395-0933
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Fax |
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Provider Business Mailing Address
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Address Line | 29601 TULIPWOOD ST
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City | MENIFEE
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State | CA
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Zip | 92584-5219
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Country | US
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Telephone | 909-262-5524
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14035
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License Number State | CA
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