MEDICARE: MS. JENNIFER CATHLEEN HOUSEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1134283591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER CATHLEEN HOUSEMAN

Provider Business Mailing Address
First Line	:	2001 JUNIPERO SERRA BLVD
Second Line	:	STE 500
City	:	DALY CITY
State	:	CA
Zip	:	94014-3888
Country	:	US
Telephone Number	:	410-409-4093
Fax Number	:

Provider Business Practice Location Address
First Line	:	1390 MARKET ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-5402
Country	:	US
Telephone Number	:	410-409-4093
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	02/11/2022

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