Provider Demographics
NPI:1093188427
Name:LUDWIG, JENIFER KRISTEN (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:KRISTEN
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:KRISTEN
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMF
Mailing Address - Street 1:5027 DEL MONTE AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-6230
Mailing Address - Country:US
Mailing Address - Phone:951-941-9392
Mailing Address - Fax:
Practice Address - Street 1:3737 MORAGA AVE STE A203
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-5491
Practice Address - Country:US
Practice Address - Phone:619-363-1920
Practice Address - Fax:619-363-4326
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85436106H00000X
CA121125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist