Provider Demographics
NPI:1093299018
Name:HERSHEY, JENNIFER E (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:HERSHEY
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:PO BOX 2045
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-6045
Mailing Address - Country:US
Mailing Address - Phone:626-921-5411
Mailing Address - Fax:
Practice Address - Street 1:236 W MOUNTAIN ST STE 202E
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-2969
Practice Address - Country:US
Practice Address - Phone:626-921-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108718106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist