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NPI Code Detail

MEDICARE: JENNIFER A GORMAN MFT

MEDICARE: JENNIFER A GORMAN 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 TherapistMFT 35787CA

General Provider Information

NPI Number : 1366599367
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER A GORMAN MFT
Provider Business Mailing Address
First Line : 43520 DIVISION ST
Second Line :
City : LANCASTER
State : CA
Zip : 93535-4089
Country : US
Telephone Number : 661-816-7979
Fax Number : 661-285-0101
Provider Business Practice Location Address
First Line : 43520 DIVISION ST
Second Line :
City : LANCASTER
State : CA
Zip : 93535-4089
Country : US
Telephone Number : 661-816-7979
Fax Number : 661-285-0101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 11/23/2020

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Directions to “ JENNIFER A GORMAN MFT” Practice Location

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