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NPI Code Detail

MEDICARE: MS. JENNIFER J DUKE MFT

MEDICARE: MS. JENNIFER J DUKE MFT
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
1106H00000XMarriage & Family TherapistMFC42153CA

General Provider Information

NPI Number : 1336271931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER J DUKE MFT
Provider Business Mailing Address
First Line : 410 W STOCKER ST APT A
Second Line :
City : GLENDALE
State : CA
Zip : 91202-4309
Country : US
Telephone Number : 818-547-1654
Fax Number :
Provider Business Practice Location Address
First Line : 867 ATCHISON ST
Second Line :
City : PASADENA
State : CA
Zip : 91104-2314
Country : US
Telephone Number : 626-798-0915
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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