Provider Demographics
NPI:1033381454
Name:JENNIFER ANN CORY
Entity Type:Organization
Organization Name:JENNIFER ANN CORY
Other - Org Name:DR JENNIFER MESSIER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MESSIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-723-3378
Mailing Address - Street 1:140 ENCINITAS BLVD
Mailing Address - Street 2:# 204
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2108
Mailing Address - Country:US
Mailing Address - Phone:619-723-3378
Mailing Address - Fax:619-243-7206
Practice Address - Street 1:511 ENCINITAS BLVD
Practice Address - Street 2:SUITE 100 UNIT J
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1366
Practice Address - Country:US
Practice Address - Phone:619-723-3378
Practice Address - Fax:619-243-7206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20743261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)