Provider Demographics
NPI:1346370038
Name:HUNTER, JAYN AARON (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:MRS
First Name:JAYN
Middle Name:AARON
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EAST DEL MAR BLVD.
Mailing Address - Street 2:SUITE 119
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:323-258-1758
Mailing Address - Fax:
Practice Address - Street 1:200 EAST DEL MAR BLVD.
Practice Address - Street 2:SUITE 119
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:323-258-1758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS98051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS9805OtherCALIFORNIA BOARD OF BEHAV
CALCS9805OtherCALIF. LIC.
SW9805Medicare UPIN