Provider Demographics
NPI:1558779074
Name:AMANO, JENNIFER ANN
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:AMANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:STRINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:3017 TELEGRAPH AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2049
Mailing Address - Country:US
Mailing Address - Phone:510-926-6677
Mailing Address - Fax:
Practice Address - Street 1:465 CALIFORNIA ST STE 470
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-1804
Practice Address - Country:US
Practice Address - Phone:628-200-0904
Practice Address - Fax:415-252-4790
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COMFT0002127106H00000X
CA110598106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health