Provider Demographics
NPI:1528540465
Name:HENNINGFIELD, JENNIFER AUDETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AUDETTE
Last Name:HENNINGFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25663 ESTORIL ST
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2545
Mailing Address - Country:US
Mailing Address - Phone:661-259-4655
Mailing Address - Fax:
Practice Address - Street 1:28494 WESTINGHOUSE PL STE 213
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0934
Practice Address - Country:US
Practice Address - Phone:661-259-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS160001041C0700X
ORL142131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical