Provider Demographics
NPI:1013223536
Name:FLOWERS, JENNIFER AMANDA (PSY D, MFT)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:AMANDA
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:PSY D, MFT
Other - Prefix:DR
Other - First Name:JENNA
Other - Middle Name:AMANDA
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, MFT
Mailing Address - Street 1:1000 QUAIL ST STE 275
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2743
Mailing Address - Country:US
Mailing Address - Phone:949-863-9031
Mailing Address - Fax:949-863-3132
Practice Address - Street 1:1000 QUAIL ST STE 275
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2743
Practice Address - Country:US
Practice Address - Phone:949-863-9031
Practice Address - Fax:949-863-3132
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist