Provider Demographics
NPI:1093389355
Name:WHITE, JENNIFER E (AMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:WHITE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14859 ROUND VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-4637
Mailing Address - Country:US
Mailing Address - Phone:310-483-2326
Mailing Address - Fax:
Practice Address - Street 1:4221 WILSHIRE BLVD STE 170-16
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3519
Practice Address - Country:US
Practice Address - Phone:213-441-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist