Provider Demographics
NPI:1477823730
Name:JENKINS, AMBER LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LEE
Last Name:JENKINS
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 1:1735A UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4406
Mailing Address - Country:US
Mailing Address - Phone:415-373-3649
Mailing Address - Fax:415-345-1923
Practice Address - Street 1:1735A UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4406
Practice Address - Country:US
Practice Address - Phone:415-373-3649
Practice Address - Fax:415-345-1923
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23003103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical