Provider Demographics
NPI:1164685541
Name:URNAZA, JENNIFER (MFT-INTERN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:URNAZA
Suffix:
Gender:F
Credentials:MFT-INTERN
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SCHEINZEIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT-INTERN
Mailing Address - Street 1:360 N SEPULVEDA BLVD
Mailing Address - Street 2:2075
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4460
Mailing Address - Country:US
Mailing Address - Phone:310-414-2090
Mailing Address - Fax:310-414-2096
Practice Address - Street 1:360 N SEPULVEDA BLVD
Practice Address - Street 2:2075
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4460
Practice Address - Country:US
Practice Address - Phone:310-414-2090
Practice Address - Fax:310-414-2096
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50850106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50850OtherMFT -INTERN