Provider Demographics
NPI:1356834865
Name:HAHN, JEANNIE (LMFT PHD)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:LMFT PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27530 LONGHILL DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3713
Mailing Address - Country:US
Mailing Address - Phone:310-490-4685
Mailing Address - Fax:
Practice Address - Street 1:27530 LONGHILL DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-3713
Practice Address - Country:US
Practice Address - Phone:310-490-4685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41518101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health