Provider Demographics
NPI:1346448990
Name:WARD, JILL-ARMANDA (LMFT)
Entity Type:Individual
Prefix:
First Name:JILL-ARMANDA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JILL-ARMANDA
Other - Middle Name:
Other - Last Name:BOLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:215 LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-2506
Mailing Address - Country:US
Mailing Address - Phone:530-338-4882
Mailing Address - Fax:
Practice Address - Street 1:215 LAKE BLVD PMB#351
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-2802
Practice Address - Country:US
Practice Address - Phone:530-338-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53625106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist