Provider Demographics
NPI:1184017428
Name:EMERSON, JANA JENSEN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:JENSEN
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MISS
Other - First Name:JANA
Other - Middle Name:KAY
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:1008 VARSITY CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3655
Mailing Address - Country:US
Mailing Address - Phone:408-806-5397
Mailing Address - Fax:
Practice Address - Street 1:1020 CORPORATION WAY
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4328
Practice Address - Country:US
Practice Address - Phone:408-806-5397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist