Provider Demographics
NPI:1275759896
Name:BERNHOFT, JENNIFER LEIGH (MFT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:BERNHOFT
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 1:5500 TORRANCE BLVD
Mailing Address - Street 2:B216
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4047
Mailing Address - Country:US
Mailing Address - Phone:310-990-4425
Mailing Address - Fax:
Practice Address - Street 1:5500 TORRANCE BLVD.
Practice Address - Street 2:B216
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4460
Practice Address - Country:US
Practice Address - Phone:310-990-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist