Provider Demographics
NPI:1477029940
Name:DURANT, JACOB (LMFT)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:DURANT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 RIDGEWOOD DR STE 9
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7803
Mailing Address - Country:US
Mailing Address - Phone:530-891-0973
Mailing Address - Fax:
Practice Address - Street 1:1370 RIDGEWOOD DR STE 9
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7803
Practice Address - Country:US
Practice Address - Phone:530-891-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101082106H00000X
CA123634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist