Provider Demographics
NPI:1083904452
Name:INSLEE, JEFFREY DAVID (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DAVID
Last Name:INSLEE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 PALMETTO
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
Mailing Address - Country:US
Mailing Address - Phone:530-519-5690
Mailing Address - Fax:530-891-5478
Practice Address - Street 1:669 PALMETTO AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-4058
Practice Address - Country:US
Practice Address - Phone:530-519-5690
Practice Address - Fax:530-891-5478
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist