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General NPI Number Information
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NPI Number | 1699664813
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Entity Type | Organization
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Legal Business Name | JENNIFER A RAY LICENSED CLINICAL SOCIAL WORKER
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 15233 VENTURA BLVD STE 500
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2231
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Country | US
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Telephone | 661-874-7851
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Fax |
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Provider Business Mailing Address
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Address Line | 15233 VENTURA BLVD STE 500
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2231
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Country | US
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Telephone | 805-729-1766
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NICOLE SEGROVES
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Credential |
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Telephone | 661-874-7851
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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 |
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License Number State |
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