Provider Demographics
NPI:1437683828
Name:YOZAMP-METTER, JENNIFER JUNE (CLC, CCSC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JUNE
Last Name:YOZAMP-METTER
Suffix:
Gender:F
Credentials:CLC, CCSC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JUNE
Other - Last Name:METTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLC, CCSC
Mailing Address - Street 1:21500 CALIFA ST UNIT 191
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4959
Mailing Address - Country:US
Mailing Address - Phone:541-598-5477
Mailing Address - Fax:
Practice Address - Street 1:10921 WILSHIRE BLVD STE 1203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4005
Practice Address - Country:US
Practice Address - Phone:800-322-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OOO106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician