Provider Demographics
NPI:1033396825
Name:TANNER, JENIFER MICHELLE (MFTT)
Entity Type:Individual
Prefix:MS
First Name:JENIFER
Middle Name:MICHELLE
Last Name:TANNER
Suffix:
Gender:F
Credentials:MFTT
Other - Prefix:MISS
Other - First Name:JENIFER
Other - Middle Name:MICHELLE
Other - Last Name:BLOCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25121 LINDA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5339
Mailing Address - Country:US
Mailing Address - Phone:949-370-4959
Mailing Address - Fax:
Practice Address - Street 1:801 E. CHAPMAN AVE.
Practice Address - Street 2:FLORENCE CRITTENTON SERVICES OF ORANGE COUNTY, INC.
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3839
Practice Address - Country:US
Practice Address - Phone:714-680-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health