Provider Demographics
NPI:1043429335
Name:LEZIN, JENNIFER SALZ (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SALZ
Last Name:LEZIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 PARKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3449
Mailing Address - Country:US
Mailing Address - Phone:650-327-5313
Mailing Address - Fax:
Practice Address - Street 1:900 N SAN ANTONIO RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1373
Practice Address - Country:US
Practice Address - Phone:650-948-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL005562104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical