Provider Demographics
NPI:1427389196
Name:BUTAH, JENNY SILBER (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JENNY SILBER
Middle Name:
Last Name:BUTAH
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 1:5905 SOQUEL DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073
Mailing Address - Country:US
Mailing Address - Phone:831-475-8712
Mailing Address - Fax:
Practice Address - Street 1:5905 SOQUEL DR STE 400
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2850
Practice Address - Country:US
Practice Address - Phone:831-475-8712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist