Provider Demographics
NPI:1437898889
Name:JENNIFER L. PIPER PSYCHOLOGIST, INC.
Entity Type:Organization
Organization Name:JENNIFER L. PIPER PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIPER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:619-629-5221
Mailing Address - Street 1:3344 4TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5704
Mailing Address - Country:US
Mailing Address - Phone:619-629-5221
Mailing Address - Fax:
Practice Address - Street 1:3344 4TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5704
Practice Address - Country:US
Practice Address - Phone:619-629-5221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty