MEDICARE: JENNIFER LYNN HENSHAW MS, 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	101YM0800X	Mental Health Counselor	107485	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107485	OTHER	CA	CALIFORNIA BOARD OF BEHAVIORAL SCIENCE

General Provider Information

NPI Number	:	1346736600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN HENSHAW MS, LMFT

Provider Business Mailing Address
First Line	:	5800 HAMNER AVE SPC 149
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-4638
Country	:	US
Telephone Number	:	909-205-7085
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 HAMNER AVE SPC 149
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-4638
Country	:	US
Telephone Number	:	909-346-5521
Fax Number	:

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	04/23/2026

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