Provider Demographics
NPI:1508499138
Name:DAHLQUIST, JENNA LILY (MHS)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LILY
Last Name:DAHLQUIST
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 DELA VINA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3974
Mailing Address - Country:US
Mailing Address - Phone:831-440-7030
Mailing Address - Fax:831-647-3004
Practice Address - Street 1:343 DELA VINA AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3974
Practice Address - Country:US
Practice Address - Phone:831-440-7030
Practice Address - Fax:831-647-3004
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor