Provider Demographics
NPI:1104845262
Name:HOUTS, JEAN BETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:BETH
Last Name:HOUTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S CEDROS AVE
Mailing Address - Street 2:210
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1945
Mailing Address - Country:US
Mailing Address - Phone:858-481-8860
Mailing Address - Fax:858-481-1779
Practice Address - Street 1:415 S CEDROS AVE
Practice Address - Street 2:210
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1945
Practice Address - Country:US
Practice Address - Phone:858-481-8860
Practice Address - Fax:858-481-1779
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 86921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health