Provider Demographics
NPI:1407523681
Name:ZUCKER, JENNA LAUREN (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:JENNA
Middle Name:LAUREN
Last Name:ZUCKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3928 OLEANDER CT APT E
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3521
Mailing Address - Country:US
Mailing Address - Phone:818-585-4799
Mailing Address - Fax:
Practice Address - Street 1:3928 OLEANDER CT APT E
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3521
Practice Address - Country:US
Practice Address - Phone:818-585-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145162106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist