Provider Demographics
NPI:1467595355
Name:SCHERE, JENNIFER JILL (PHD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JILL
Last Name:SCHERE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3236 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-1342
Mailing Address - Country:US
Mailing Address - Phone:619-992-4917
Mailing Address - Fax:
Practice Address - Street 1:3356 2ND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5636
Practice Address - Country:US
Practice Address - Phone:619-269-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16972103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical