MEDICARE: MS. JENNIFER ANN CASEY LMFT

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	106H00000X	Marriage & Family Therapist	137546	CA

General Provider Information

NPI Number	:	1164115044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER ANN CASEY LMFT

Provider Business Mailing Address
First Line	:	700 FREDERICK ST STE 103
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2239
Country	:	US
Telephone Number	:	831-291-5935
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 FREDERICK ST STE 103
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2239
Country	:	US
Telephone Number	:	831-291-5935
Fax Number	:

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

Provider Enumeration Date	:	05/29/2023
Last Update Date	:	06/04/2026

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