Provider Demographics
NPI:1225166366
Name:KAPLAN, JILL M (MFT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 WILLOW ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-2380
Mailing Address - Country:US
Mailing Address - Phone:650-364-4670
Mailing Address - Fax:408-885-0591
Practice Address - Street 1:913 WILLOW ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-2380
Practice Address - Country:US
Practice Address - Phone:650-364-4670
Practice Address - Fax:408-885-0591
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39315106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist