Provider Demographics
NPI:1093115545
Name:HOWARD, JENNA MARQUEZ (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:MARQUEZ
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SKYLARK DR APT 22
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1223
Mailing Address - Country:US
Mailing Address - Phone:650-888-5891
Mailing Address - Fax:
Practice Address - Street 1:10 SKYLARK DR APT 22
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1223
Practice Address - Country:US
Practice Address - Phone:650-888-5891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128187106H00000X
CA102134106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist