Provider Demographics
NPI:1164744520
Name:DEL BOSQUE, JEFFREY EDWARD (LMFT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:EDWARD
Last Name:DEL BOSQUE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W THOUSAND OAKS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4462
Mailing Address - Country:US
Mailing Address - Phone:805-907-1178
Mailing Address - Fax:
Practice Address - Street 1:125 W THOUSAND OAKS BLVD STE 500
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4462
Practice Address - Country:US
Practice Address - Phone:805-777-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health