Provider Demographics
NPI:1235206806
Name:COZEN, JARED JONAS (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:JONAS
Last Name:COZEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8238
Mailing Address - Country:US
Mailing Address - Phone:925-777-6226
Mailing Address - Fax:925-777-6363
Practice Address - Street 1:3454 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8238
Practice Address - Country:US
Practice Address - Phone:925-777-6226
Practice Address - Fax:925-777-6363
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40403106H00000X
CAPSY 28732103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist