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General NPI Number Information
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NPI Number | 1952406126
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Entity Type | Individual
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Provider Name | JANE GIVENS JORGENSEN LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1110 CALIFORNIA BLVD STE E
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2317
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Country | US
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Telephone | 805-782-9338
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Fax | 805-594-0401
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Provider Business Mailing Address
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Address Line | 369 CHORRO STREET
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-2317
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Country | US
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Telephone | 805-782-9338
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Fax | 805-594-0401
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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 | LMFT32132
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License Number State | CA
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